CMS-1500 Box 24J / 33a • NPI
1306305115
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP0808X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health
Box 32 Service Location & ZIP+4
75 EXECUTIVE DR STE 339, AURORA, IL, 60504-8124
✓ 9-Digit EDI 837 ZIP+4 (60504-8124)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1306305115 (LAWRENCE EDO ABAH, APN) 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
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1306305115)
Medicare Beneficiaries
97
Total Billed Services
1,604
Distinct CPT/HCPCS Codes
8
Medicare Allowed Total
$159,583.27
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
90792 | Psychiatric diagnostic evaluation with medical services | 37 |
90833 | Psychotherapy with evaluation and management visit, 30 minutes | 758 |
96136 | Administration of psychological or neuropsychological test, first 30 minutes | 23 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 379 |
99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 383 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Alprazolam Alprazolam | 93 | 17 |
| Amitriptyline Hcl Amitriptyline Hcl | 15 | <11 |
| Aripiprazole Aripiprazole | 17 | <11 |
| Bupropion Xl Bupropion Hcl | 20 | <11 |
| Clonazepam Clonazepam | 26 | <11 |
| Clopidogrel Clopidogrel Bisulfate | 12 | <11 |
| Dextroamphetamine-Amphetamine Dextroamphetamine/Amphetamine | 28 | <11 |
| Doxepin Hcl Doxepin Hcl | 11 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1306305115 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | LAWRENCE EDO ABAH, APN |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health NUCC Code: 363LP0808X (Nurse Practitioner, Psych/Mental Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 75 EXECUTIVE DR STE 339, AURORA, IL, 60504-8124 |
| Practice Telephone / Fax | Tel: (773) 772-7858 |
| Administrative Mailing Address | 75 EXECUTIVE DR STE 447, AURORA, IL, 60504-8112 |
| Enumeration & Last Sync | Enumerated: 2019-03-19 | CMS Record Updated: 2025-03-16 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP0808X)
What Does Taxonomy Code 363LP0808X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (LAWRENCE EDO ABAH, APN)
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 |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: IL | License: 209018813 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: IL | License: 209018813 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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