CMS-1500 Box 24J / 33a • NPI
1790407740
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
183500000X
Licensed & Credentialed Pharmacist
Box 32 Service Location & ZIP+4
977 HIGHWAY 98 E, DESTIN, FL, 32541-2801
✓ 9-Digit EDI 837 ZIP+4 (32541-2801)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1790407740 (ALYSSA BACLIG) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1790407740 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ALYSSA BACLIG |
| Plain-English Specialty | Licensed & Credentialed Pharmacist NUCC Code: 183500000X (Pharmacist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 977 HIGHWAY 98 E, DESTIN, FL, 32541-2801 |
| Practice Telephone / Fax | Tel: (850) 650-4538 |
| Administrative Mailing Address | 200 PAGE BACON RD APT 4106, MARY ESTHER, FL, 32569-1767 |
| Enumeration & Last Sync | Enumerated: 2022-09-15 | CMS Record Updated: 2022-09-15 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (183500000X)
What Does Taxonomy Code 183500000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 183500000X translates to:
"Licensed & Credentialed Pharmacist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ALYSSA BACLIG)
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
- 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 |
|---|---|
183500000X — PharmacistPlain English: Licensed & Credentialed Pharmacist | State: CA | License: 86147 | Primary: Secondary |
183500000X — PharmacistPlain English: Licensed & Credentialed Pharmacist | State: FL | License: 64637 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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