CMS-1500 Box 24J / 33a • NPI
1356502116
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207RG0100X (CMS 10)
Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)
Box 32 Service Location & ZIP+4
24411 HEALTH CENTER DR STE 430, LAGUNA HILLS, CA, 92653-3633
✓ 9-Digit EDI 837 ZIP+4 (92653-3633)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1356502116 (DALIA AL-MUDALLAL, 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 #1356502116)
Medicare Beneficiaries
281
Total Billed Services
553
Distinct CPT/HCPCS Codes
14
Medicare Allowed Total
$77,742.48
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
45380 | Biopsy of large bowel using a flexible endoscope | 18 |
99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 144 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 247 |
G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 37 |
G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito | 61 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Cholestyramine Cholestyramine (With Sugar) | 15 | <11 |
| Famotidine Famotidine | 113 | 49 |
| Linzess Linaclotide | 12 | <11 |
| Omeprazole Omeprazole | 28 | 11 |
| Ondansetron Odt Ondansetron | 11 | <11 |
| Pantoprazole Sodium Pantoprazole Sodium | 91 | 35 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1356502116 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | DALIA AL-MUDALLAL, M.D. |
| Plain-English Specialty | Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) NUCC Code: 207RG0100X (Internal Medicine, Gastroenterology) |
| Certifying / Licensing Body | American Board of Internal Medicine — Gastroenterology |
| Practice Location Address | 24411 HEALTH CENTER DR STE 430, LAGUNA HILLS, CA, 92653-3633 |
| Practice Telephone / Fax | Tel: (949) 452-3933 | Fax: (949) 458-1291 |
| Administrative Mailing Address | 14252 CULVER DR # A338, IRVINE, CA, 92604-0317 |
| Enumeration & Last Sync | Enumerated: 2008-06-24 | CMS Record Updated: 2025-10-16 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207RG0100X)
What Does Taxonomy Code 207RG0100X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RG0100X translates to:
"Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (DALIA AL-MUDALLAL, M.D.)
Typical CPT / Diagnostic Procedures:- Screening & Diagnostic Colonoscopy with Polypectomy (CPT 45378–45385)
- Esophagogastroduodenoscopy / Upper GI Endoscopy (EGD — CPT 43239)
- Hepatic Elastography (FibroScan) & Fractionated Bilirubin/LFT Workup
- Internal Hemorrhoid Banding & Anorectal Diagnostic Evaluation
- Proton Pump Inhibitors (Omeprazole, Pantoprazole, Esomeprazole)
- H. pylori Quadruple & Triple Eradication Regimens
- Mesalamine & Biologic Immunomodulators (Inflammatory Bowel Disease)
- Osmotic Laxatives, Rifaximin & Ursodeoxycholic Acid
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207RG0100X — Internal Medicine, GastroenterologyPlain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) | State: CA | License: A131849 | Primary: Yes (Primary) |
207RG0100X — Internal Medicine, GastroenterologyPlain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) | State: VA | License: 0101248509 | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: TN | License: 73892 | Primary: Secondary |
207RG0100X — Internal Medicine, GastroenterologyPlain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) | State: AZ | License: 76377 | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: VA | License: 0101248509 | Primary: Secondary |
207RG0100X — Internal Medicine, GastroenterologyPlain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) | State: TN | License: 73892 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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