CMS-1500 Box 24J / 33a • NPI
1659612927
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
2865X1600X (CMS A0[7])
Accredited Inpatient Medical & Surgical Hospital (24/7 Emergency & ICU Care)
Box 32 Service Location & ZIP+4
USS TRUXTUN, DDG 103, FPO, AE, 09588-1309
✓ 9-Digit EDI 837 ZIP+4 (09588-1309)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1659612927 (MICHAEL OTHELLO MATHIS, Surface Force IDC) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1659612927 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MICHAEL OTHELLO MATHIS, Surface Force IDC |
| Plain-English Specialty | Accredited Inpatient Medical & Surgical Hospital (24/7 Emergency & ICU Care) NUCC Code: 2865X1600X (Military Hospital, Military General Acute Care Hospital. Operational (Transportable)) |
| Certifying / Licensing Body | The Joint Commission (TJC) / CMS Conditions of Participation (CoP) |
| Practice Location Address | USS TRUXTUN, DDG 103, FPO, AE, 09588-1309 |
| Practice Telephone / Fax | Tel: (757) 445-6164 |
| Administrative Mailing Address | USS TRUXTUN, FPO, AE, 09588-1309 |
| Enumeration & Last Sync | Enumerated: 2013-03-11 | CMS Record Updated: 2013-03-11 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (2865X1600X)
What Does Taxonomy Code 2865X1600X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2865X1600X translates to:
"Accredited Inpatient Medical & Surgical Hospital (24/7 Emergency & ICU Care)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MICHAEL OTHELLO MATHIS, Surface Force IDC)
Typical CPT / Diagnostic Procedures:- Emergency Department Resuscitation & Trauma Stabilization (CPT 99281–99285)
- Inpatient Acute Medical & Critical Care Admission (DRG / CPT 99221–99291)
- Cross-Sectional Diagnostic Imaging: CT, MRI & Ultrasound
- Inpatient General, Orthopedic & Cardiothoracic Surgery
- 24-Hour Clinical Laboratory, Blood Bank & Microbiology Services
- Broad-Spectrum IV Antimicrobials (Ceftriaxone, Piperacillin-Tazobactam, Vancomycin, Linezolid)
- Parenteral Anticoagulants & Thrombolytics (Heparin, Enoxaparin, Alteplase)
- Balanced Crystalloid Infusions & Oral Rehydration Protocols
- Perioperative Anesthetics, Vasopressors & Analgesics
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
2865X1600X — Military Hospital, Military General Acute Care Hospital. Operational (Transportable)Plain English: Accredited Inpatient Medical & Surgical Hospital (24/7 Emergency & ICU Care) | State: CA | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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