Individual provider Active NPI

Brandon D Nelson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Issaquah, WA
National Provider Identifier
1871781245
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO60003506 Issued in WA
Practice address
450 NW Gilman Blvd
303
Issaquah, WA 98027-2483
Phone
(425) 391-8666
Fax
(425) 392-6433
NPI assigned
Oct 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X PO60003506 WA
Foot & Ankle Surgery Podiatrist 213ES0103X PO60003506 WA Primary

Addresses

Primary practice location

450 NW Gilman Blvd
303
Issaquah, WA 98027-2483

Mailing address

450 NW Gilman Blvd
303
Issaquah, WA 98027-2483
Phone (425) 391-8666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090811000752 WA Practitioner - Podiatry 3375697279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Issaquah Foot and Ankle Specialists, P.L.L.C.Group PAC ID 7618139577, 3 clinicians

Practice addresses (Care Compare)

450 NW Gilman Blvd
Suite 303
Issaquah, WA 98027-2483
Phone (425) 391-8666

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions42
Removal of nail tissue43
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Issaquah Foot & Ankle Specialists, P.L.L.C. Primary Podiatric Medicine CurrentSince Jan 1, 2012 Accepting new patients
Issaquah Foot & Ankle Specialists PLLC CurrentSince Jan 1, 2012 Accepting new patients

Locations

450 NW Gilman Blvd
Ste 303
Issaquah, WA 98027
Phone (425) 310-2542

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1871781245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD",
            "address_2": "303",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-391-8666",
            "fax_number": "425-392-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD",
            "address_2": "303",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-391-8666",
            "fax_number": "425-392-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRANDON",
        "middle_name": "D",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "WA",
            "license": "PO60003506",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO60003506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.