Individual provider Active NPI

Michael Connor, MD

  • Radiation Oncology Physician
  • Lacey, WA
National Provider Identifier
1285165142
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD61319209 Issued in WA
Practice address
4525 3Rd Ave SE # 100
Lacey, WA 98503-1010
Phone
(360) 412-8960
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD61319209 WA Primary

Addresses

Primary practice location

4525 3Rd Ave SE # 100
Lacey, WA 98503-1010

Mailing address

4525 3Rd Ave SE # 100
Olympia, WA 98503-1010

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
I20230222001458 WA Practitioner - Radiation Oncology 9931572963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Radiantcare Physicians PLLCGroup PAC ID 6608869581, 5 clinicians

Practice addresses (Care Compare)

4525 3Rd Ave SE
Suite 100
Lacey, WA 98503-1010
Phone (360) 412-8960

Hospital & facility affiliations

  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304
  • Capital Medical Center Hospital, Olympia, WA, CCN 500139

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiantcare Physicians, PLLC Radiation Oncology CurrentSince Feb 20, 2023 Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

1200 Basich Blvd
Aberdeen, WA 98520
Phone (360) 537-8801

2015 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 330-8939

4525 3rd Ave SE
#100
Olympia, WA 98503
Phone (360) 412-8960

Organizations & group practices 3

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 5

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1285165142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE # 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985031010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE # 100",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-412-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD61319209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.