CMS-1500 Box 24J / 33a • NPI
1891159745
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
450077 STATE ROAD 200 STE 12, CALLAHAN, FL, 32011-3863
✓ 9-Digit EDI 837 ZIP+4 (32011-3863)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1891159745 (PHILLIPS CAO) 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 #1891159745)
Medicare Beneficiaries
155
Total Billed Services
907
Distinct CPT/HCPCS Codes
34
Medicare Allowed Total
$55,613.29
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 | 136 |
90662 | Influenza vaccine split virus, preservative free | 25 |
93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 11 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 136 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 168 |
G0008 | Administration of influenza virus vaccine | 29 |
G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 56 |
G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 250 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 90 | 27 |
| Allopurinol Allopurinol | 19 | <11 |
| Alprazolam Alprazolam | 194 | 34 |
| Amlodipine Besylate Amlodipine Besylate | 124 | 43 |
| Amoxicillin Amoxicillin | 25 | 16 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 21 | 15 |
| Atenolol Atenolol | 32 | <11 |
| Atorvastatin Calcium Atorvastatin Calcium | 146 | 50 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1891159745 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | PHILLIPS CAO |
| 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 | 450077 STATE ROAD 200 STE 12, CALLAHAN, FL, 32011-3863 |
| Practice Telephone / Fax | Tel: (904) 633-0561 | Fax: (315) 801-3565 |
| Administrative Mailing Address | 120 HOBART ST, UTICA, NY, 13501-4308 |
| Enumeration & Last Sync | Enumerated: 2016-04-07 | CMS Record Updated: 2019-06-18 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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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 (PHILLIPS CAO)
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: FL | License: ME140356 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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