NPIMap

Individual provider Active NPI

Ioan Vlad Nicolescu, MD

  • Internal Medicine Physician
  • Lacey, WA
National Provider Identifier
1053501452
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60664294 Issued in WA
Practice address
2555 Marvin Rd NE
Lacey, WA 98516-3138
Phone
(360) 493-7800
NPI assigned
Jul 31, 2007
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60664294 WA Primary

Addresses

Primary practice location

2555 Marvin Rd NE
Lacey, WA 98516-3138

Mailing address

2555 Marvin Rd NE
Lacey, WA 98516-3138
Phone (360) 493-7800

Other practice location 1

600 E Main St
Elma, WA 98541-9560
Phone (360) 346-2222

Other identifiers 1

IdentifierTypeStateIssuer
64133745MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161021001077 WA Practitioner - Internal Medicine 3274701552 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

579 E Main St
Elma, WA 98541-9551
Phone (360) 346-2222

600 E Main St
Elma, WA 98541-9560
Phone (360) 346-2222

610 E Main St
Elma, WA 98541-9353
Phone (360) 346-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60664294WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor County Public Hospital District No 1 CurrentSince Mar 15, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 8, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 8, 2019 Accepting new patients
Grays Harbor County Public Hospital District No 1 CurrentSince Mar 15, 2021 Accepting new patients
Grays Harbor County Public Hospital District No 1 CurrentSince Mar 15, 2021 Accepting new patients

Locations

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

610 E Main St
Elma, WA 98541
Phone (360) 346-2222

105 W Simpson Ave
McCleary, WA 98557
Phone (360) 346-2222

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1053501452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 MARVIN RD NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163138",
            "telephone_number": "360-493-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 MARVIN RD NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163138",
            "telephone_number": "360-493-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 E Main St",
            "address_purpose": "LOCATION",
            "city": "Elma",
            "state": "WA",
            "postal_code": "985419560",
            "country_code": "US",
            "telephone_number": "360-346-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLESCU",
        "first_name": "IOAN",
        "middle_name": "VLAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60664294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64133745",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.