CMS-1500 Box 24J / 33a • NPI
1043410145
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207RC0000X (CMS 06)
Board-Certified Cardiologist (Heart & Blood Vessel Specialist)
Box 32 Service Location & ZIP+4
2900 BRADFORD ST NE, GRAND RAPIDS, MI, 49525-6427
✓ 9-Digit EDI 837 ZIP+4 (49525-6427)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1043410145 (WISSAM MOHAMAD ABDALLAH, M.D.) 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1043410145)
Medicare Beneficiaries
1,245
Total Billed Services
2,125
Distinct CPT/HCPCS Codes
43
Medicare Allowed Total
$105,530.15
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
75561 | Mri scan of heart before and after contrast | 81 |
75563 | Mri scan of heart before and after contrast with stress imaging | 22 |
75565 | Mri scan of blood flow of heart | 66 |
76377 | 3d radiographic procedure with computerized image postprocessing | 12 |
78431 | Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan | 21 |
78434 | Nuclear medicine study of heart muscle blood flow by pet | 21 |
78452 | Nuclear medicine studies of heart muscle at rest and with stress and spect | 53 |
78452 | Nuclear medicine studies of heart muscle at rest and with stress and spect | 20 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amiodarone Hcl Amiodarone Hcl | 42 | 21 |
| Amlodipine Besylate Amlodipine Besylate | 102 | 44 |
| Atorvastatin Calcium Atorvastatin Calcium | 127 | 61 |
| Carvedilol Carvedilol | 111 | 40 |
| Chlorthalidone Chlorthalidone | 12 | <11 |
| Clopidogrel Clopidogrel Bisulfate | 12 | <11 |
| Diltiazem 24hr Er (Cd) Diltiazem Hcl | 27 | 11 |
| Doxazosin Mesylate Doxazosin Mesylate | 28 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1043410145 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | WISSAM MOHAMAD ABDALLAH, M.D. |
| Plain-English Specialty | Board-Certified Cardiologist (Heart & Blood Vessel Specialist) NUCC Code: 207RC0000X (Internal Medicine, Cardiovascular Disease) |
| Certifying / Licensing Body | American Board of Internal Medicine — Cardiovascular Disease |
| Practice Location Address | 2900 BRADFORD ST NE, GRAND RAPIDS, MI, 49525-6427 |
| Practice Telephone / Fax | Tel: (616) 885-5000 | Fax: (616) 885-5020 |
| Administrative Mailing Address | 100 MICHIGAN ST NE, GRAND RAPIDS, MI, 49503-2560 |
| Enumeration & Last Sync | Enumerated: 2007-07-18 | CMS Record Updated: 2026-08-11 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207RC0000X)
What Does Taxonomy Code 207RC0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RC0000X translates to:
"Board-Certified Cardiologist (Heart & Blood Vessel Specialist)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (WISSAM MOHAMAD ABDALLAH, M.D.)
Typical CPT / Diagnostic Procedures:- Transthoracic Doppler Echocardiography (TTE — CPT 93306)
- 12-Lead Electrocardiogram (ECG) & Holter / Event Arrhythmia Monitoring
- Exercise Treadmill & Myocardial Perfusion Nuclear Stress Testing
- Diagnostic Coronary Angiography & Percutaneous Coronary Intervention (PCI)
- High-Intensity Statins (Atorvastatin, Rosuvastatin) & Ezetimibe
- Beta-Blockers (Metoprolol Succinate, Carvedilol, Bisoprolol)
- Sacubitril/Valsartan, Empagliflozin & Spironolactone (Heart Failure GDMT)
- Apixaban, Rivaroxaban & Clopidogrel (Atrial Fibrillation & Stent Thrombosis Prevention)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: MI | License: 4301090289 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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