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GORDON S NISHIMOTO DPM
NPI 1356334460
Podiatrist - Foot & Ankle Surgery in Everett, WA

Active since August 24, 2005PECOS EnrolledAccepts Medicare Assignment
10821 19TH AVE SE STE 201, EVERETT, WA 98208(425) 337-7000(425) 338-2408 Get Directions Write a Review

NPPES record last updated: December 3, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 31, 2025, Dec 3, 2018 (2 updates tracked since 2018).

About Gordon S Nishimoto Dpm NPPES

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

GORDON S NISHIMOTO DPM (NPI 1356334460) is an individual foot & ankle surgery provider in Everett, Washington, licensed in Washington (PO00000725) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Providence Regional Medical Center Everett, and is a graduate of California School Of Podiatric Medicine (1998).

NPPES Registry Identity

NPI1356334460
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameGORDON S NISHIMOTOCredential: DPM
Location Address10821 19TH AVE SE STE 201Everett, WA 98208-5103
Mailing Address15428 14th Dr SeMill Creek, WA 98012-8467 · (425) 337-7000 · Fax (425) 338-2408
Phone(425) 337-7000
Fax(425) 338-2408
Sole ProprietorYes
Medical School CMSCalifornia School Of Podiatric MedicineGraduated 1998
Enumeration DateAugust 24, 2005
Last NPPES UpdateDecember 3, 20182 updates tracked since enumeration
✔ NPI 1356334460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in WA · PO00000725
10821 19TH AVE SE STE 201, Everett, WA 98208
Open in Google Maps ↗

Other Identifiers 1

Medicaid8484396WA

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gordon S Nishimoto Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527954999
PECOS Enrollment IDI20110204000068
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Gordon Nishimoto reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Proliance Surgeons, Inc., P.S.
Same address
Podiatrist
10821 19TH AVE SE STE 201
Everett, WA 98208
  • Reassigned Medicare billing, Washington enrollment
  • 589 clinicians in this Medicare group
NPI 1275345456 (425) 337-7000
Northwest Foot And Ankle Physicians And Surgeons, LLC
Same address
Podiatrist
10821 19TH AVE SE
Everett, WA 98208
  • Reassigned Medicare billing, Washington enrollment
  • 3 clinicians in this Medicare group
NPI 1477640779 (425) 337-7000

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

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
141 services75 patients
X-ray of foot, 2 views 73620
An X-ray of the foot, 2 views, is a quick, painless test that produces images of the bones and structures inside your foot. Two different angles are used to provide a comprehensive view. This helps doctors diagnose fractures, infections, or other abnormalities.
77 services32 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
60 services15 patients
Removal of noncancer thickened skin growth, 2-4 growths 11056
This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.
55 services15 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
21 services14 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence Regional Medical Center Everett

Acute Care Hospitals · Everett, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500014
Location1321 Colby AvenueEverett, WA 98201 · Snohomish County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROLIANCE SURGEONS, INC., P.S.
Podiatrist
10821 19TH AVE SE STE 201
EVERETT, WA 98208
Snohomish County (425) 337-7000

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 Gordon Nishimoto's NPI number?

The NPI number for Gordon Nishimoto is 1356334460. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Gordon Nishimoto located?

Gordon Nishimoto practices at 10821 19th Ave SE Ste 201, Everett, WA 98208. The listed phone number is (425) 337-7000.

What is Gordon Nishimoto's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Gordon Nishimoto enrolled in Medicare?

Yes. Gordon Nishimoto is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Gordon Nishimoto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gordon Nishimoto reassigns Medicare benefits to 2 organizations: Proliance Surgeons, Inc., P.S. (Everett, WA) and Northwest Foot And Ankle Physicians And Surgeons, LLC (Everett, WA). Each 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 Gordon Nishimoto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gordon Nishimoto accept?

Health plans from Ambetter Health, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Gordon Nishimoto 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.

Is Gordon Nishimoto affiliated with any hospitals?

According to CMS data, Gordon Nishimoto is affiliated with Providence Regional Medical Center Everett.

When was this NPI record last updated?

The NPPES record for Gordon Nishimoto was last updated on December 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.