Dr Mark Dale Nellermoe, DPM - Medicare Podiatrist in University Place, WA

Dr Mark Dale Nellermoe, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in University Place, Washington. He graduated from medical school in 1981 and has 43 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Fasa Family Wellness Pllc and his current practice location is 3929 Bridgeport Way W Ste 308, University Place, Washington. You can reach out to his office (for appointments etc.) via phone at (253) 627-4181.

Dr Mark Dale Nellermoe is licensed to practice in Washington (license number PO00000507) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1386733541.

Contact Information

Dr Mark Dale Nellermoe, DPM
3929 Bridgeport Way W Ste 308,
University Place, WA 98466-4455
(253) 627-4181
(253) 272-5922



Healthcare Provider's Profile

Full NameDr Mark Dale Nellermoe
GenderMale
SpecialityPodiatry
Experience43 Years
Location3929 Bridgeport Way W Ste 308, University Place, Washington
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Mark Dale Nellermoe graduated from medical school in 1981
  NPI Data:
  • NPI Number: 1386733541
  • Provider Enumeration Date: 10/12/2006
  • Last Update Date: 07/11/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 3971795287
  • Enrollment ID: I20101005000882

Medical Identifiers

Medical identifiers for Dr Mark Dale Nellermoe such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1386733541NPI-NPPES
GAB02027OtherWAMEDICARE ID
1102375MedicaidWA
990007694OtherWARAILROAD MEDICARE ID
0039635OtherWADEPARTMENT OF LABOR & IND
1386733541OtherWANPI #

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213ES0103XPodiatrist - Foot & Ankle Surgery PO00000507 (Washington)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mark Dale Nellermoe allows following entities to bill medicare on his behalf.
Provider NameMark D Nellermoe Professional Service Corporation
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1194145094
PECOS PAC ID: 9436377504
Enrollment ID: O20140903000307

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Provider NameFasa Family Wellness Pllc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1790181899
PECOS PAC ID: 7618290297
Enrollment ID: O20150107000888

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark Dale Nellermoe is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mark Dale Nellermoe, DPM
3929 Bridgeport Way W Ste 308,
University Place, WA 98466-4455

Ph: (253) 627-4181
Dr Mark Dale Nellermoe, DPM
3929 Bridgeport Way W Ste 308,
University Place, WA 98466-4455

Ph: (253) 627-4181

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Podiatrist in University Place, WA

Mark D Nellermoe Professional Service Corporation
Podiatrist
Medicare: Medicare Enrolled
Practice Location: 3929 Bridgeport Way W Ste 308, University Place, WA 98466
Phone: 253-627-4181    Fax: 253-272-5922
Dr. Cynthia A Fenberg, DPM
Podiatrist
Medicare: Accepting Medicare Assignments
Practice Location: 5225 Cirque Dr W, Suite 100, University Place, WA 98467
Phone: 253-474-4353    Fax: 253-474-5850
Cynthia A Fenberg
Podiatrist
Medicare: Medicare Enrolled
Practice Location: 5225 Cirque Dr W, Ste 100, University Place, WA 98467
Phone: 253-474-4353    Fax: 253-474-5850
Caleb Paul Thomas, DPM
Podiatrist
Medicare: Medicare Enrolled
Practice Location: 3929 Bridgeport Way W Ste 308, University Place, WA 98466
Phone: 253-272-2999    Fax: 253-272-4699
Dr. Thomas Matthew Burghardt, D.P.M.
Podiatrist
Medicare: Accepting Medicare Assignments
Practice Location: 3929 Bridgeport Way W Ste 308, University Place, WA 98466
Phone: 253-272-2999    Fax: 253-272-4699

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