CMS-1500 Box 24J / 33a • NPI
1689886962
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207RH0003X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
210 W MCKINLEY AVE STE 1, DECATUR, IL, 62526-5858
✓ 9-Digit EDI 837 ZIP+4 (62526-5858)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1689886962 (EVELENA ONTIVEROS, MD PhD) 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 #1689886962)
Medicare Beneficiaries
613
Total Billed Services
182,322
Distinct CPT/HCPCS Codes
191
Medicare Allowed Total
$2,478,521.10
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
36415 | Insertion of needle into vein for collection of blood sample | 1,155 |
36591 | Collection of blood sample from implanted device | 118 |
71250 | Ct scan of chest without contrast | 32 |
71260 | Ct scan of chest with contrast | 89 |
74176 | Ct scan of abdomen and pelvis without contrast | 16 |
74177 | Ct scan of abdomen and pelvis with contrast | 80 |
77080 | Dxa bone density measurement of hip, pelvis, spine | 17 |
78815 | Nuclear medicine study from skull base to mid-thigh with ct scan | 36 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Abiraterone Acetate Abiraterone Acetate | 32 | <11 |
| Acetaminophen-Codeine Acetaminophen With Codeine | 38 | 20 |
| Acyclovir Acyclovir | 19 | <11 |
| Albuterol Sulfate Hfa Albuterol Sulfate | 13 | <11 |
| Allopurinol Allopurinol | 24 | <11 |
| Alprazolam Alprazolam | 15 | <11 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 12 | <11 |
| Anastrozole Anastrozole | 54 | 20 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1689886962 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | EVELENA ONTIVEROS, MD PhD |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207RH0003X (Internal Medicine, Hematology & Oncology) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 210 W MCKINLEY AVE STE 1, DECATUR, IL, 62526-5858 |
| Practice Telephone / Fax | Tel: (217) 876-6600 | Fax: (217) 876-6606 |
| Administrative Mailing Address | 210 W MCKINLEY AVE STE 1, DECATUR, IL, 62526-5858 |
| Enumeration & Last Sync | Enumerated: 2007-05-07 | CMS Record Updated: 2025-11-12 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207RH0003X)
What Does Taxonomy Code 207RH0003X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RH0003X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (EVELENA ONTIVEROS, MD PhD)
Typical CPT / Diagnostic Procedures:- Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
- Preoperative Medical Risk Assessment & Cardiac Clearance
- Chronic Kidney, Hepatic & Metabolic Panel Interpretation
- Adult Inpatient Hospitalist Management & Discharge Coordination
- Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
- Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
- Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
- Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207RH0003X — Internal Medicine, Hematology & OncologyPlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: IL | License: 036143984 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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