Proliance Surgeons Ankle and Foot of Edmonds – Foot & Ankle Surgery Podiatrist, NPI 1659871622
Foot & Ankle Surgery Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Proliance Surgeons Ankle and Foot of Edmonds
216th Street Southwest, Edmonds, Snohomish County, Washington, 98026, United States
EDMONDS, WA 980268006
Phone: (425) 775-6996
Fax: (425) 670-8905
Type: Location
901, Madison Street, Central Business District, First Hill, Seattle, King County, Washington, 98104, United States
SEATTLE, WA 981041172
Phone: (206) 264-8100
Type: Mailing
7320 216TH ST SW STE 320
EDMONDS, WA 980268006
Phone: (425) 673-3900
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: 2018-09-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (957 days ago).
Enrollment records
2
Earliest due date
2023-10-31
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 |
|---|---|---|---|---|
| O20031119000128 | O | Clinic/Group Practice | WA | TBD |
| O20180904002901 | O | Physician - Podiatry | WA | 2023-10-31 |
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 98026)
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