CMS-1500 Box 24J / 33a • NPI
1619460938
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363AM0700X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical
Box 32 Service Location & ZIP+4
4500 S LANCASTER RD, DALLAS, TX, 75216-7167
✓ 9-Digit EDI 837 ZIP+4 (75216-7167)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1619460938 (OLABAMIJI KAZEEM ABIMBOLA, DSc, PA-C) 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 #1619460938)
Medicare Beneficiaries
447
Total Billed Services
1,075
Distinct CPT/HCPCS Codes
7
Medicare Allowed Total
$87,108.30
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 18 |
99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 281 |
99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 720 |
99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 28 |
G0317 | Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi | 14 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amlodipine Besylate Amlodipine Besylate | 11 | <11 |
| Furosemide Furosemide | 19 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1619460938 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | OLABAMIJI KAZEEM ABIMBOLA, DSc, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical NUCC Code: 363AM0700X (Physician Assistant, Medical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 4500 S LANCASTER RD, DALLAS, TX, 75216-7167 |
| Practice Telephone / Fax | Tel: (401) 365-0464 |
| Administrative Mailing Address | 4500 S LANCASTER RD, DALLAS, TX, 75216-7167 |
| Enumeration & Last Sync | Enumerated: 2018-06-12 | CMS Record Updated: 2021-12-21 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363AM0700X)
What Does Taxonomy Code 363AM0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AM0700X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (OLABAMIJI KAZEEM ABIMBOLA, DSc, PA-C)
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 |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: MA | License: PA6600 | Primary: Secondary |
363AS0400X — Physician Assistant, SurgicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Surgical | State: MA | License: PA6600 | Primary: Secondary |
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: TX | License: PA13372 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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