Individual provider Active NPI

Ronald S Goldberg, MD PHD

  • Specialist
  • Lacey, WA
National Provider Identifier
1659378941
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00017869 Issued in WA
Practice address
4525 3Rd Ave SE
Ste 200
Lacey, WA 98503-1010
Phone
(360) 412-8909
Fax
(360) 412-8954
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00017869 WA Primary

Addresses

Primary practice location

4525 3Rd Ave SE
Ste 200
Lacey, WA 98503-1010

Mailing address

4525 3Rd Ave SE
Ste 200
Lacey, WA 98503-1010
Phone (360) 412-8909

Other identifiers 1

IdentifierTypeStateIssuer
1054675MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Medical Physicians CurrentSince Jan 23, 2013 Accepting new patients
Capital Oncology PLLC Past Accepting new patients
Argus Oncology LLC PastSince Apr 30, 2003 Accepting new patients

Locations

923 Georgiana St
Port Angeles, WA 98362
Phone (360) 457-4496

433 E 8th St
Port Angeles, WA 98362
Phone (360) 452-3373

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.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659378941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE",
            "address_2": "STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-412-8909",
            "fax_number": "360-412-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE",
            "address_2": "STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-412-8909",
            "fax_number": "360-412-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "RONALD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00017869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1054675",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.