DR. MARK DALE NELLERMOE (D.P.M.) – Foot & Ankle Surgery Podiatrist, NPI 1386733541
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
360 PODIATRY in WA
Provider Addresses for DR. MARK DALE NELLERMOE (D.P.M.)
3929 BRIDGEPORT WAY W STE 308
UNIVERSITY PLACE, WA 984664455
Phone: (253) 627-4181
Fax: (253) 272-5922
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-10-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101005000882 | I | Podiatry | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11721 | Removal of fingernails or toenails, 6 or more nails | 890 | 351 | $0 |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 493 | 149 | $0 |
| 11056 | Removal of noncancer thickened skin growth, 2-4 growths | 455 | 220 | $0 |
| 11057 | Removal of noncancer thickened skin growth, more than 4 growths | 169 | 98 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 83 | 55 | $0 |
Insurance plans in this area (ZIP 98466)
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Provider's Procedures
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