CMS-1500 Box 24J / 33a • NPI
1790882595
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207Q00000X (CMS 08)
Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)
Box 32 Service Location & ZIP+4
1995 HIGHWAY 51 S, SUITE 202, NORTH DOCTORS BUILDING, COVINGTON, TN, 38019-3635
✓ 9-Digit EDI 837 ZIP+4 (38019-3635)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1790882595 (SAMUEL LEE BROFFITT, M.D.) 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 #1790882595)
Medicare Beneficiaries
212
Total Billed Services
943
Distinct CPT/HCPCS Codes
19
Medicare Allowed Total
$87,806.07
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
90658 | Influenza vaccine, trivalent, 0.5 ml dosage | 51 |
96372 | Injection of drug or substance under skin or into muscle | 51 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 677 |
99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 21 |
G0008 | Administration of influenza virus vaccine | 58 |
J1010 | Injection, methylprednisolone acetate, 1 mg | 19 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Acetaminophen-Codeine Acetaminophen With Codeine | 12 | <11 |
| Albuterol Sulfate Hfa Albuterol Sulfate | 17 | <11 |
| Allopurinol Allopurinol | 45 | 15 |
| Alprazolam Alprazolam | 12 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 143 | 40 |
| Amlodipine Besylate-Benazepril Amlodipine Besylate/Benazepril | 15 | <11 |
| Amoxicillin Amoxicillin | 15 | 11 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 22 | 19 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1790882595 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SAMUEL LEE BROFFITT, M.D. |
| Plain-English Specialty | Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) NUCC Code: 207Q00000X (Family Medicine) |
| Certifying / Licensing Body | American Board of Family Medicine (ABFM) |
| Practice Location Address | 1995 HIGHWAY 51 S, SUITE 202, NORTH DOCTORS BUILDING, COVINGTON, TN, 38019-3635 |
| Practice Telephone / Fax | Tel: (901) 476-4526 |
| Administrative Mailing Address | PO BOX 784, COVINGTON, TN, 38019-0784 |
| Enumeration & Last Sync | Enumerated: 2006-09-20 | CMS Record Updated: 2007-07-08 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207Q00000X)
What Does Taxonomy Code 207Q00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Q00000X translates to:
"Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SAMUEL LEE BROFFITT, M.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Annual Preventive Physical Examination & Cardiometabolic Screening
- Outpatient ECG / EKG Interpretation (CPT 93000) & Ambulatory BP Monitoring
- Point-of-Care HbA1c, Lipid Panel, Urinalysis & BMI Risk Stratification
- Minor Office Procedures: Wound Suturing, Abscess Drainage & Joint Injections
- Adult & Pediatric Immunization Administration (Tetanus/Tdap, Influenza, HPV)
- Metformin, SGLT2 Inhibitors & GLP-1 Receptor Agonists (Type 2 Diabetes)
- Lisinopril, Losartan & Amlodipine (First-Line Hypertension Management)
- Atorvastatin & Rosuvastatin (Cardiovascular Lipid Optimization)
- Nitrofurantoin, Trimethoprim-Sulfamethoxazole & Ciprofloxacin (Outpatient UTIs)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: TN | License: MD13148 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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