CMS-1500 Box 24J / 33a • NPI
1063289247
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207PE0004X (CMS 93)
Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)
Box 32 Service Location & ZIP+4
1145 S UTICA AVE STE 365, TULSA, OK, 74104-4004
✓ 9-Digit EDI 837 ZIP+4 (74104-4004)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1063289247 (YEGANEH AZIMI, PAC) 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
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1063289247)
Medicare Beneficiaries
129
Total Billed Services
170
Distinct CPT/HCPCS Codes
15
Medicare Allowed Total
$10,148.82
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 29 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 62 |
99283 | Emergency department visit with low level of medical decision making | 19 |
99284 | Emergency department visit with moderate level of medical decision making | 31 |
99285 | Emergency department visit with high level of medical decision making | 15 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 15 | 15 |
| Amoxicillin Amoxicillin | 16 | 16 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 12 | 12 |
| Azithromycin Azithromycin | 12 | 12 |
| Cephalexin Cephalexin | 19 | 19 |
| Methylprednisolone Methylprednisolone | 20 | 20 |
| Mupirocin Mupirocin | 13 | 13 |
| Ondansetron Odt Ondansetron | 16 | 16 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1063289247 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | YEGANEH AZIMI, PAC |
| Plain-English Specialty | Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: 207PE0004X (Emergency Medicine, Emergency Medical Services) |
| Certifying / Licensing Body | American Board of Emergency Medicine (ABEM) |
| Practice Location Address | 1145 S UTICA AVE STE 365, TULSA, OK, 74104-4004 |
| Practice Telephone / Fax | Tel: (918) 728-3354 |
| Administrative Mailing Address | 1157 E 148TH ST S, GLENPOOL, OK, 74033-4407 |
| Enumeration & Last Sync | Enumerated: 2023-12-07 | CMS Record Updated: 2023-12-07 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207PE0004X)
What Does Taxonomy Code 207PE0004X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207PE0004X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (YEGANEH AZIMI, PAC)
Typical CPT / Diagnostic Procedures:- Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
- Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
- Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting
- Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
- Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
- Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207PE0004X — Emergency Medicine, Emergency Medical ServicesPlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: OK | License: 5141 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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