Olympia Podiatry Clinic – Podiatrist, NPI 1558897942
Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Olympia Podiatry Clinic
Ensign Road Northeast, Olympia, Thurston County, Washington, 98506-5049, United States
OLYMPIA, WA 985065065
Phone: (360) 943-9600
Fax: (360) 943-9694
Type: Location
1420 Carpenter Rd SE
Lacey, WA 985032905
Phone: (360) 943-9600
Fax: (360) 943-9694
Type: Location
9403 Phillips Ln NE
Lacey, WA 985167163
Phone: (360) 943-9600
Fax: (360) 943-9694
Type: Location
9119, Classic Drive Northeast, Lacey, Thurston County, Washington, 98516, United States
LACEY, WA 985169247
Phone: (216) 469-5758
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-03-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (741 days ago).
Enrollment records
2
Earliest due date
2024-05-31
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 |
|---|---|---|---|---|
| O20170717002311 | O | Clinic/Group Practice | WA | 2024-05-31 |
| O20180320003254 | O | Physician - Podiatry | WA | 2026-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98506)
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