ALLERGY & ASTHMA CENTER OF LACEY, LLC — NPI 1366565087 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology in FORKED RIVER, NJ)

CMS-1500 Box 24J / 33a • NPI

1366565087

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207K00000X (CMS 03)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology

Box 32 Service Location & ZIP+4

606 LACEY RD, FORKED RIVER, NJ, 08731-2205

✓ 9-Digit EDI 837 ZIP+4 (08731-2205)

Practice Phone & Referral Fax

(609) 693-6464

Fax: (609) 693-6334

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1366565087 (ALLERGY & ASTHMA CENTER OF LACEY, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1366565087` (NPI-2 Organization / Facility)
Provider / Legal Name	ALLERGY & ASTHMA CENTER OF LACEY, LLC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology NUCC Code: `207K00000X` (Allergy & Immunology)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	606 LACEY RD, FORKED RIVER, NJ, 08731-2205
Practice Telephone / Fax	Tel: (609) 693-6464 \| Fax: (609) 693-6334
Administrative Mailing Address	606 LACEY RD, FORKED RIVER, NJ, 08731-2205
Enumeration & Last Sync	Enumerated: 2007-04-09 \| CMS Record Updated: 2008-06-24
Authorized Official	JANET TUMALIUAN (OWNER)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

606 LACEY RD, FORKED RIVER, NJ, 08731-2205

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Plain-English Taxonomy & CMS Crosswalk (207K00000X)

What Does Taxonomy Code 207K00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207K00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 03 (Physician/Allergy/ Immunology)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Allergy & Immunology for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALLERGY & ASTHMA CENTER OF LACEY, LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207K00000X` — Allergy & Immunology Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology	State: NJ \| License: `MA65918` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ALLERGY & ASTHMA CENTER OF LACEY, LLC (NPI #1366565087)