NPIMap

Organization Active NPI

PNC Podiatry of Washington PLLC

  • Foot & Ankle Surgery Podiatrist
  • Seattle, WA
National Provider Identifier
1659249126
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PNC PODIATRY OF WASHINGTON PLLC
Practice address
600 Broadway Ste 220
Seattle, WA 98122-5373
Phone
(206) 344-3808
Fax
(206) 860-0907
NPI assigned
Oct 27, 2025
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alexander Reyzelman, DPMNPI 1023192721
Title
Cmo
Phone
(415) 292-0638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

600 Broadway Ste 220
Seattle, WA 98122-5373

Mailing address

PO Box 36326
Belfast, ME 04915-1205
Phone (206) 344-3808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260309002959 WA DME Supplier - Physician - Podiatry 3971950312 Practice locations: Seattle, WA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
PNC Podiatry of Washington9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

16030 Bothell Everett Hwy
Ste 160
Mill Creek, WA 98012
Phone (425) 537-3777

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1659249126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36326",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151205",
            "telephone_number": "206-344-3808",
            "fax_number": "206-860-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 220",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225373",
            "telephone_number": "206-344-3808",
            "fax_number": "206-860-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNC PODIATRY OF WASHINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "REYZELMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "415-292-0638",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.