Individual provider Active NPI

Marcus John Lacey

  • Diagnostic Radiology Physician
  • Seattle, WA
National Provider Identifier
1124524087
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD61086344 Issued in WA
Practice address
925 Seneca St
Seattle, WA 98101-2742
Phone
(206) 583-6079
NPI assigned
Mar 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD61086344 WA Primary

Addresses

Primary practice location

925 Seneca St
Seattle, WA 98101-2742

Mailing address

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 583-6079

Other practice location 1

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318003379 WA Practitioner - Diagnostic Radiology 2860748050 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians
Union Avenue Open MRI LLCGroup PAC ID 5597652917, 44 clinicians

Practice addresses (Care Compare)

13728 Goodrich Dr NW
Gig Harbor, WA 98329-8643
Phone (253) 761-4200

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61086344WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tra-Minw P S CurrentSince May 1, 2024 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Feb 1, 2025 Accepting new patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Tra-Minw P S CurrentSince May 1, 2024 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince May 1, 2024 Accepting new patients
The Carol Milgard Breast Center Past Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance Past Accepting new patients

Locations (25 of 55)

122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750

205 10th St NE
Auburn, WA 98002
Phone (253) 351-5300

21110 Sr 410 E
Ste 110
Bonney Lake, WA 98391

9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000

5900 State Highway 303 NE
Bremerton, WA 98311
Phone (253) 459-6633

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

16045 1st Ave S
Burien, WA 98148
Phone (206) 965-4100

27111 167th Pl SE
Ste 101
Covington, WA 98042

1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615

3021 Griffin Ave
Enumclaw, WA 98022
Phone (253) 833-6241

30809 1st Ave S
Federal Way, WA 98003
Phone (253) 839-2030

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

34503 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8280

11567 Canterwood Blvd
Gig Harbor, WA 98332
Phone (253) 530-2000

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

5122 Olympic Dr
Ste A203
Gig Harbor, WA 98335
Phone (253) 530-8000

6140 E Lake Sammamish Pkwy SE
Ste F
Issaquah, WA 98029

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

12475 Totem LK Blvd NE
Kirkland, WA 98034

9537 Gravelly Lake Dr SW
Ste E10
Lakewood, WA 98499
Phone (253) 984-2000

24080 SE Kent Kangley Rd
Maple Valley, WA 98038
Phone (253) 372-7680

3822 116th St NE
Marysville, WA 98271

800 164th St SE
Ste P
Mill Creek, WA 98012
Phone (425) 434-4231

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 7

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

Hospital & facility affiliations 9

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": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1124524087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SENECA ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012742",
            "telephone_number": "206-583-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SENECA ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012742",
            "telephone_number": "206-583-6079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Fawcett Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984021900",
            "country_code": "US",
            "telephone_number": "253-761-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "MARCUS",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-31",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD61086344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.