CMS-1500 Box 24J / 33a • NPI
1174630529
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
208G00000X (CMS 02)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery)
Box 32 Service Location & ZIP+4
14540 CORTEZ BLVD, SUITE 123, BROOKSVILLE, FL, 34613-6056
✓ 9-Digit EDI 837 ZIP+4 (34613-6056)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1174630529 (CHARLES JOHN ABLAN, 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1174630529 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | CHARLES JOHN ABLAN, M.D. |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery) NUCC Code: 208G00000X (Thoracic Surgery (Cardiothoracic Vascular Surgery)) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 14540 CORTEZ BLVD, SUITE 123, BROOKSVILLE, FL, 34613-6056 |
| Practice Telephone / Fax | Tel: (352) 596-1513 | Fax: (352) 596-5918 |
| Administrative Mailing Address | 4264 BRAEMERE DR, SPRING HILL, FL, 34609-0682 |
| Enumeration & Last Sync | Enumerated: 2006-08-23 | CMS Record Updated: 2023-03-07 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208G00000X)
What Does Taxonomy Code 208G00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208G00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (CHARLES JOHN ABLAN, M.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
208G00000X — Thoracic Surgery (Cardiothoracic Vascular Surgery)Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery) | State: AR | License: E-4352 | Primary: Secondary |
208G00000X — Thoracic Surgery (Cardiothoracic Vascular Surgery)Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery) | State: WI | License: 35260 | Primary: Secondary |
208G00000X — Thoracic Surgery (Cardiothoracic Vascular Surgery)Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery) | State: FL | License: 106333 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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