DR. MARK DALE NELLERMOE D.P.M.
NPI 1386733541
Podiatrist - Foot & Ankle Surgery in University Place, WA
About Dr. Mark Dale Nellermoe D.p.m. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARK DALE NELLERMOE D.P.M. (NPI 1386733541) is an individual foot & ankle surgery provider in University Place, Washington, licensed in Washington (PO00000507) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1981).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 6
Accepted 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
Dr. Mark Dale Nellermoe D.p.m. 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.
Medicare Billing Reassignments
2Medicare enrollment records show Mark Nellermoe reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
University Place, WA 98466
- Reassigned Medicare billing, Washington enrollment
Tumwater, WA 98512
- Reassigned Medicare billing, Washington enrollment
- 23 clinicians in this Medicare group
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.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
UNIVERSITY PLACE, WA 98466
UNIVERSITY PLACE, WA 98466
UNIVERSITY PLACE, WA 98466
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 Nellermoe's NPI number?
The NPI number for Mark Nellermoe is 1386733541. It was assigned to this individual provider in the NPPES registry on October 12, 2006.
Where is Mark Nellermoe located?
Mark Nellermoe practices at 3929 Bridgeport Way W Ste 308, University Place, WA 98466. The listed phone number is (253) 627-4181.
What is Mark Nellermoe's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Mark Nellermoe enrolled in Medicare?
Yes. Mark Nellermoe 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 Mark Nellermoe's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Nellermoe reassigns Medicare benefits to 2 organizations: Mark D Nellermoe Professional Service Corporation (University Place, WA) and Fasa Family Wellness, PLLC (Tumwater, 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 Mark Nellermoe's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mark Nellermoe accept?
Health plans from Ambetter Health, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Mark Nellermoe 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 Nellermoe was last updated on July 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Dr. Mark Dale Nellermoe, D.P.M. · NPI 1386733541
Foot & Ankle Surgery provider in University Place, Washington. Individual provider, active in the CMS NPPES registry since October 12, 2006.
## Identity
- **NPI:** 1386733541 (Entity type: Individual)
- **Enumerated:** October 12, 2006
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **State license:** PO00000507 (Washington)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3929 BRIDGEPORT WAY W STE 308, University Place, WA 98466-4455
- **Phone:** (253) 627-4181 · **Fax:** (253) 272-5922
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Mark D Nellermoe Professional Service Corporation (NPI 1194145094, University Place, WA); Fasa Family Wellness, PLLC (NPI 1790181899, Tumwater, WA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1981
## Record status
- **NPPES last updated:** July 11, 2011
- **Other identifiers:** Other 990007694 (WA); Other 1386733541 (WA); Medicare UPIN U48440 (WA); and 3 more
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Source: [NPI Profile](https://npiprofile.com/npi/1386733541) · Data from the CMS NPPES public registry.