CMS-1500 Box 24J / 33a • NPI
1629763552
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
542435 US HIGHWAY 1, CALLAHAN, FL, 32011-3497
✓ 9-Digit EDI 837 ZIP+4 (32011-3497)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1629763552 (JALEESA BACHMANN) 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 #1629763552)
Medicare Beneficiaries
162
Total Billed Services
654
Distinct CPT/HCPCS Codes
35
Medicare Allowed Total
$19,836.67
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
71046 | X-ray of chest, 2 views | 15 |
81003 | Automated urinalysis test | 27 |
87804 | Detection test by immunoassay with direct visual observation for influenza virus | 61 |
87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 53 |
87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 16 |
96372 | Injection of drug or substance under skin or into muscle | 34 |
99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 47 |
99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 20 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 13 | <11 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 14 | 14 |
| Azithromycin Azithromycin | 24 | 24 |
| Cephalexin Cephalexin | 30 | 30 |
| Doxycycline Monohydrate Doxycycline Monohydrate | 26 | 23 |
| Methylprednisolone Methylprednisolone | 12 | 11 |
| Prednisone Prednisone | 26 | 25 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1629763552 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JALEESA BACHMANN |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 542435 US HIGHWAY 1, CALLAHAN, FL, 32011-3497 |
| Practice Telephone / Fax | Tel: (904) 507-4623 |
| Administrative Mailing Address | 1500 1ST AVE N UNIT 3, BIRMINGHAM, AL, 35203-1866 |
| Enumeration & Last Sync | Enumerated: 2023-04-06 | CMS Record Updated: 2023-04-06 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JALEESA BACHMANN)
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: FL | License: APRN11025658 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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