CMS-1500 Box 24J / 33a • NPI
1124341060
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207QA0401X (CMS 08)
Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)
Box 32 Service Location & ZIP+4
1750 BRIDGEWAY, SUITE B105, SAUSALITO, CA, 94965-1993
✓ 9-Digit EDI 837 ZIP+4 (94965-1993)
⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT:
NPI
1124341060 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(b)(4) — License Revocation, Suspension, or Surrender — Effective 2015-10-20; Sec. 1128(a)(4) — Felony Controlled Substance Conviction — Effective 2018-01-18). Verify before submitting Medicare/Medicaid claims.
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1124341060 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MICHAEL R. CHIAROTTINO, M.D. |
| Plain-English Specialty | Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) NUCC Code: 207QA0401X (Family Medicine, Addiction Medicine) |
| Certifying / Licensing Body | American Board of Family Medicine (ABFM) |
| Practice Location Address | 1750 BRIDGEWAY, SUITE B105, SAUSALITO, CA, 94965-1993 |
| Practice Telephone / Fax | Tel: (415) 331-2113 | Fax: (415) 331-2114 |
| Administrative Mailing Address | 1750 BRIDGEWAY, SAUSALITO, CA, 94965-1993 |
| Enumeration & Last Sync | Enumerated: 2010-03-07 | CMS Record Updated: 2010-03-07 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207QA0401X)
What Does Taxonomy Code 207QA0401X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207QA0401X translates to:
"Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MICHAEL R. CHIAROTTINO, M.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Annual Preventive Physical Examination & Cardiometabolic Screening
- Outpatient ECG / EKG Interpretation (CPT 93000) & Ambulatory BP Monitoring
- Point-of-Care HbA1c, Lipid Panel, Urinalysis & BMI Risk Stratification
- Minor Office Procedures: Wound Suturing, Abscess Drainage & Joint Injections
- Adult & Pediatric Immunization Administration (Tetanus/Tdap, Influenza, HPV)
- Metformin, SGLT2 Inhibitors & GLP-1 Receptor Agonists (Type 2 Diabetes)
- Lisinopril, Losartan & Amlodipine (First-Line Hypertension Management)
- Atorvastatin & Rosuvastatin (Cardiovascular Lipid Optimization)
- Nitrofurantoin, Trimethoprim-Sulfamethoxazole & Ciprofloxacin (Outpatient UTIs)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207QA0401X — Family Medicine, Addiction MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: CA | License: #G39528 | Primary: Yes (Primary) |
208VP0000X — Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine | State: CA | License: G39528 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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