CMS-1500 Box 24J / 33a • NPI
1831148501
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207N00000X (CMS 07)
Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)
Box 32 Service Location & ZIP+4
1111 GRAND AVE STE K, DIAMOND BAR, CA, 91765-4172
✓ 9-Digit EDI 837 ZIP+4 (91765-4172)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1831148501 (SAM ABAZA, 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 #1831148501)
Medicare Beneficiaries
635
Total Billed Services
3,116
Distinct CPT/HCPCS Codes
108
Medicare Allowed Total
$863,795.08
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
11102 | Biopsy of related skin growth, first growth | 87 |
11103 | Biopsy of related skin growth, each additional growth | 96 |
11300 | Shaving of skin growth of body, arms, or legs, 0.5 cm or less | 43 |
11301 | Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm | 22 |
11305 | Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less | 16 |
11310 | Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less | 12 |
13101 | Complicated repair of wound of trunk, 2.6-7.5 cm | 13 |
13121 | Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm | 66 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Betamethasone Dipropionate Betamethasone Dipropionate | 35 | 17 |
| Cephalexin Cephalexin | 167 | 145 |
| Clobetasol Propionate Clobetasol Propionate | 11 | <11 |
| Fluocinonide Fluocinonide | 13 | <11 |
| Gentamicin Sulfate Gentamicin Sulfate | 167 | 151 |
| Hydrocortisone Hydrocortisone | 15 | 13 |
| Ketoconazole Ketoconazole | 22 | <11 |
| Metronidazole Metronidazole | 11 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1831148501 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SAM ABAZA, M.D. |
| Plain-English Specialty | Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) NUCC Code: 207N00000X (Dermatology) |
| Certifying / Licensing Body | American Board of Dermatology (ABD) |
| Practice Location Address | 1111 GRAND AVE STE K, DIAMOND BAR, CA, 91765-4172 |
| Practice Telephone / Fax | Tel: (098) 604-2549 |
| Administrative Mailing Address | 1111 GRAND AVE STE K, DIAMOND BAR, CA, 91765-4172 |
| Enumeration & Last Sync | Enumerated: 2006-05-09 | CMS Record Updated: 2025-11-17 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207N00000X)
What Does Taxonomy Code 207N00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207N00000X translates to:
"Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SAM ABAZA, M.D.)
Typical CPT / Diagnostic Procedures:- Full-Body Dermoscopy & Skin Cancer Screening
- Shave, Punch & Excisional Skin Biopsy (CPT 11102–11107)
- Cryotherapy Destruction of Actinic Keratoses & Viral Warts (CPT 17000)
- Topical Corticosteroids (Triamcinolone, Clobetasol) & Calcineurin Inhibitors
- Topical & Oral Retinoids (Tretinoin, Adapalene, Isotretinoin)
- Doxycycline, Minocycline & Antifungals (Terbinafine, Ketoconazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207ND0101X — Dermatology, MOHS-Micrographic SurgeryPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: CA | License: A86393 | Primary: Secondary |
207N00000X — DermatologyPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: CA | License: A86393 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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