Individual provider Active NPI

Lance Alfred Nethercott, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Puyallup, WA
National Provider Identifier
1891119129
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO60763120 Issued in WA
Practice address
2728 E Main Ste a
Puyallup, WA 98372-3198
Phone
(253) 848-0131
Fax
(253) 840-6787
NPI assigned
Feb 6, 2014
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO60763120 WA Primary

Addresses

Primary practice location

2728 E Main Ste a
Puyallup, WA 98372-3198

Mailing address

2728 E Main Ste a
Puyallup, WA 98372-3198
Phone (253) 848-0131

Other practice location 1

1633 N 26th St
Allentown, PA 18104-1805
Phone (610) 434-7000

Other practice location 2

10004 204th Ave E Ste 2700
Bonney Lake, WA 98391-6536
Phone (253) 862-1967

Other practice location 3

17700 SE 272nd St
370
Covington, WA 98042-4951
Phone (253) 631-0585

Other practice location 4

21137 SR 410 E Ste I
Bonney Lake, WA 98391-8775
Phone (800) 425-2805

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
I20170814002000 WA Practitioner - Podiatry 4789956582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1450 5TH St SE
Suite 4400
Puyallup, WA 98372-4691
Phone (253) 256-7048

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue64
Removal of skin lesions1-10
Removal of nail tissue371
Removal or shaving of skin growth230
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO60763120WAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Wound Healing & Dermatology CurrentSince Aug 15, 2023 Accepting new patients
Ankle & Foot Specialists of Puget Sound, PS Foot & Ankle Surgery Current Accepting new patients
Ankle & Foot Specialist of Puget Sound, PS CurrentSince Jul 10, 2017 Accepting new patients
Ankle & Foot Specialists of Puget Sound, PS Foot & Ankle Surgery CurrentSince Jul 10, 2017 Accepting new patients
Ankle & Foot Specialists of Puget Sound, PS Foot & Ankle Surgery Past Accepting new patients
Ankle & Foot Specialists of Puget Sound, PS Foot & Ankle Surgery Past Accepting new patients

Locations

10004 204th Ave E
Ste 2700
Bonney Lake, WA 98391
Phone (253) 848-6656

21137 State Route 410 E
Ste I
Bonney Lake, WA 98391
Phone (253) 862-5275

751 NE Blakely Dr
Issaquah, WA 98029
Phone (425) 313-4000

17700 SE 272nd St
#370
Kent, WA 98042
Phone (253) 631-0585

1450 5th St SE
Ste 4400
Puyallup, WA 98372
Phone (253) 697-2340

2728 E Main
Ste A
Puyallup, WA 98372
Phone (253) 841-2006

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00164
  • Direct secure messaging: lance.nethercott@aafsopsp-wa.direct.office.nextgen.com

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1891119129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 E MAIN STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723198",
            "telephone_number": "253-848-0131",
            "fax_number": "253-840-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 E MAIN STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723198",
            "telephone_number": "253-848-0131",
            "fax_number": "253-840-6787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1633 N 26th St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181041805",
            "country_code": "US",
            "telephone_number": "610-434-7000",
            "fax_number": "610-434-7029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10004 204th Ave E Ste 2700",
            "address_purpose": "LOCATION",
            "city": "Bonney Lake",
            "state": "WA",
            "postal_code": "983916536",
            "country_code": "US",
            "telephone_number": "253-862-1967",
            "fax_number": "253-862-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17700 SE 272nd St",
            "address_2": "370",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "WA",
            "postal_code": "980424951",
            "country_code": "US",
            "telephone_number": "253-631-0585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21137 SR 410 E Ste I",
            "address_purpose": "LOCATION",
            "city": "Bonney Lake",
            "state": "WA",
            "postal_code": "983918775",
            "country_code": "US",
            "telephone_number": "800-425-2805",
            "fax_number": "855-673-1403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETHERCOTT",
        "first_name": "LANCE",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO60763120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.