CMS-1500 Box 24J / 33a • NPI
1164975835
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207RA0001X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
800 ROSE ST, LEXINGTON, KY, 40536-3055
✓ 9-Digit EDI 837 ZIP+4 (40536-3055)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1164975835 (SONU SUSAN ABRAHAM, 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 #1164975835)
Medicare Beneficiaries
26
Total Billed Services
91
Distinct CPT/HCPCS Codes
14
Medicare Allowed Total
$11,225.00
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 11 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Metoprolol Succinate Metoprolol Succinate | 19 | 15 |
| Spironolactone Spironolactone | 11 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1164975835 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SONU SUSAN ABRAHAM, M.D. |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207RA0001X (Internal Medicine, Advanced Heart Failure and Transplant Cardiology) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 800 ROSE ST, LEXINGTON, KY, 40536-3055 |
| Practice Telephone / Fax | Tel: (859) 323-0295 | Fax: (859) 323-1256 |
| Administrative Mailing Address | 251 E HURON ST, CHICAGO, IL, 60611-3055 |
| Enumeration & Last Sync | Enumerated: 2016-07-29 | CMS Record Updated: 2024-09-03 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207RA0001X)
What Does Taxonomy Code 207RA0001X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RA0001X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SONU SUSAN ABRAHAM, M.D.)
Typical CPT / Diagnostic Procedures:- Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
- Preoperative Medical Risk Assessment & Cardiac Clearance
- Chronic Kidney, Hepatic & Metabolic Panel Interpretation
- Adult Inpatient Hospitalist Management & Discharge Coordination
- Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
- Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
- Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
- Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: MA | License: 267481 | Primary: Secondary |
207RA0001X — Internal Medicine, Advanced Heart Failure and Transplant CardiologyPlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: IL | License: 036.165080 | Primary: Secondary |
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: KY | License: 59310 | Primary: Secondary |
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: IL | License: 036.165080 | Primary: Secondary |
207RA0001X — Internal Medicine, Advanced Heart Failure and Transplant CardiologyPlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: KY | License: 59310 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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