Individual provider Active NPI

Lorie-Mae Nicolas, MD

  • Pediatric Allergy/Immunology Physician
  • Lemoyne, PA
National Provider Identifier
1497335798
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
MD484805 Issued in PA
Practice address
3 Walnut St Ste 205
Lemoyne, PA 17043-1168
Phone
(717) 988-0090
Fax
(717) 221-5320
NPI assigned
Apr 11, 2021
Last updated
Aug 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X MD484805 PA
Pediatrics Physician 208000000X MD484805 PA
Pediatric Allergy/Immunology Physician 2080P0201X MD484805 PA Primary

Addresses

Primary practice location

3 Walnut St Ste 205
Lemoyne, PA 17043-1168

Mailing address

3 Walnut St Ste 205
Lemoyne, PA 17043-1168
Phone (717) 988-0090

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8521

Other practice location 2

21 Waterford Dr
Mechanicsburg, PA 17050-8268
Phone (717) 988-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210805000524 PA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1052715539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD484805PAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1618099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1497335798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WALNUT ST STE 205",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431168",
            "telephone_number": "717-988-0090",
            "fax_number": "717-221-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WALNUT ST STE 205",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431168",
            "telephone_number": "717-988-0090",
            "fax_number": "717-221-5320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Waterford Dr",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170508268",
            "country_code": "US",
            "telephone_number": "717-988-9180",
            "fax_number": "717-775-5723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLAS",
        "first_name": "LORIE-MAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-11",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "PA",
            "license": "MD484805",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD484805",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "PA",
            "license": "MD484805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoyne, PA

Sources for this page

Verify at the official NPI Registry.