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MARK D NELLERMOE PROFESSIONAL SERVICE CORPORATION
NPI 1194145094
Podiatrist in University Place, WA

Active since April 18, 2014
3929 BRIDGEPORT WAY W STE 308, UNIVERSITY PLACE, WA 98466(253) 627-4181(253) 272-5922 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mark D Nellermoe Professional Service Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK D NELLERMOE PROFESSIONAL SERVICE CORPORATION (NPI 1194145094) is a healthcare organization registered as a podiatrist in University Place, Washington and active in the NPI registry since April 2014. The organization lists Mark D Nellermoe, Owner, as its authorized official.

NPPES Registry Identity

NPI1194145094
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameMARK D NELLERMOE PROFESSIONAL SERVICE CORPORATION
Location Address3929 BRIDGEPORT WAY W STE 308University Place, WA 98466-4455
Mailing Address3929 Bridgeport Way W Ste 308University Place, WA 98466-4455 · (253) 627-4181 · Fax (253) 272-5922
Phone(253) 627-4181
Fax(253) 272-5922
Organization SubpartNo
Authorized OfficialMark D NellermoeOwner · (253) 627-4181
Enumeration DateApril 18, 2014
Last NPPES UpdateJune 11, 2025
NPPES CertifiedJune 11, 2025
✔ NPI 1194145094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in WA · PO00000507
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
3929 BRIDGEPORT WAY W STE 308, University Place, WA 98466
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark D Nellermoe Professional Service Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mark D Nellermoe Professional Service Corporation, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mark Nellermoe, D.P.M.
Podiatry
NPI 1386733541
3929 BRIDGEPORT WAY W STE 308
University Place, WA 98466
(253) 627-4181
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark D Nellermoe Professional Service Corporation's NPI number?

The NPI number for Mark D Nellermoe Professional Service Corporation is 1194145094. It was assigned to this organization in the NPPES registry on April 18, 2014.

Where is Mark D Nellermoe Professional Service Corporation located?

Mark D Nellermoe Professional Service Corporation is located at 3929 Bridgeport Way W Ste 308, University Place, WA 98466. The listed phone number is (253) 627-4181.

What is Mark D Nellermoe Professional Service Corporation's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Mark D Nellermoe Professional Service Corporation enrolled in Medicare?

Yes. Mark D Nellermoe Professional Service Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mark D Nellermoe Professional Service Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Mark D Nellermoe Professional Service Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mark D Nellermoe Professional Service Corporation accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Mark D Nellermoe Professional Service Corporation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark D Nellermoe Professional Service Corporation was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.