CMS-1500 Box 24J / 33a • NPI
1255813663
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
171M00000X
Licensed & Credentialed Case Manager/Care Coordinator
Box 32 Service Location & ZIP+4
1818 METZEROTT RD APT 26, ADELPHI, MD, 20783-5134
✓ 9-Digit EDI 837 ZIP+4 (20783-5134)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1255813663 (GAETTAN BAWOUNKEU) 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 | 1255813663 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | GAETTAN BAWOUNKEU |
| Plain-English Specialty | Licensed & Credentialed Case Manager/Care Coordinator NUCC Code: 171M00000X (Case Manager/Care Coordinator) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1818 METZEROTT RD APT 26, ADELPHI, MD, 20783-5134 |
| Practice Telephone / Fax | Tel: (240) 470-2658 |
| Administrative Mailing Address | 7841 RIVERDALE RD APT T3, NEW CARROLLTON, MD, 20784-4023 |
| Enumeration & Last Sync | Enumerated: 2018-08-31 | CMS Record Updated: 2023-07-26 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (171M00000X)
What Does Taxonomy Code 171M00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171M00000X translates to:
"Licensed & Credentialed Case Manager/Care Coordinator"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (GAETTAN BAWOUNKEU)
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 |
|---|---|
374U00000X — Home Health AidePlain English: CMS-Certified Home Health Care & Skilled Nursing Agency | State: DC | License: HHA13867 | Primary: Secondary |
171M00000X — Case Manager/Care CoordinatorPlain English: Licensed & Credentialed Case Manager/Care Coordinator | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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