CMS-1500 Box 24J / 33a • NPI
1255966743
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
208000000X (CMS 37)
Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)
Box 32 Service Location & ZIP+4
55 LAKE AVE N, WORCESTER, MA, 01655-0002
✓ 9-Digit EDI 837 ZIP+4 (01655-0002)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1255966743 (EBLA ABD ALRAHMAN) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1255966743 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | EBLA ABD ALRAHMAN |
| Plain-English Specialty | Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: 208000000X (Pediatrics) |
| Certifying / Licensing Body | American Board of Pediatrics (ABP) |
| Practice Location Address | 55 LAKE AVE N, WORCESTER, MA, 01655-0002 |
| Practice Telephone / Fax | Tel: (774) 442-6087 | Fax: (774) 442-6060 |
| Administrative Mailing Address | PO BOX 415348, BOSTON, MA, 02241-5348 |
| Enumeration & Last Sync | Enumerated: 2020-03-05 | CMS Record Updated: 2024-10-01 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208000000X)
What Does Taxonomy Code 208000000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208000000X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (EBLA ABD ALRAHMAN)
Typical CPT / Diagnostic Procedures:- Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
- Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
- Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
- Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
- Pediatric Asthma Nebulization & Spirometry Evaluation
- Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
- WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
- Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
- Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: CT | License: 70740 | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: MA | License: 1019360 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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