CMS-1500 Box 24J / 33a • NPI
1740480391
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207RA0001X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
200 1ST ST SW, ROCHESTER, MN, 55905-0001
✓ 9-Digit EDI 837 ZIP+4 (55905-0001)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1740480391 (OMAR F ABOU EZZEDDINE, MD) 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 #1740480391)
Medicare Beneficiaries
311
Total Billed Services
664
Distinct CPT/HCPCS Codes
21
Medicare Allowed Total
$63,162.94
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
93016 | Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician | 108 |
93018 | Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician | 108 |
99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 20 |
99205 | New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | 38 |
99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 65 |
99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 33 |
99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 234 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amlodipine Besylate Amlodipine Besylate | 25 | <11 |
| Atorvastatin Calcium Atorvastatin Calcium | 67 | 15 |
| Carvedilol Carvedilol | 36 | 15 |
| Donepezil Hcl Donepezil Hcl | 25 | <11 |
| Eliquis Apixaban | 46 | 16 |
| Entresto Sacubitril/Valsartan | 104 | 29 |
| Eplerenone Eplerenone | 11 | <11 |
| Farxiga Dapagliflozin Propanediol | 44 | 12 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1740480391 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | OMAR F ABOU EZZEDDINE, MD |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207RA0001X (Internal Medicine, Advanced Heart Failure and Transplant Cardiology) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 200 1ST ST SW, ROCHESTER, MN, 55905-0001 |
| Practice Telephone / Fax | Tel: (507) 284-2511 |
| Administrative Mailing Address | 200 1ST ST SW, ROCHESTER, MN, 55905-0001 |
| Enumeration & Last Sync | Enumerated: 2007-07-23 | CMS Record Updated: 2020-08-11 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207RA0001X)
What Does Taxonomy Code 207RA0001X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RA0001X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (OMAR F ABOU EZZEDDINE, MD)
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 |
|---|---|
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: MN | License: 50744 | Primary: Secondary |
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: MN | License: 50744 | Primary: Secondary |
207RA0001X — Internal Medicine, Advanced Heart Failure and Transplant CardiologyPlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: MN | License: 50744 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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