THEODORE REXFORD ADDAI, M.D. — NPI 1912985185 (Board-Certified Cardiologist (Heart & Blood Vessel Specialist) in DECATUR, IL)

CMS-1500 Box 24J / 33a • NPI

1912985185

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207RC0000X (CMS 06)

Board-Certified Cardiologist (Heart & Blood Vessel Specialist)

Box 32 Service Location & ZIP+4

1770 E LAKE SHORE DR STE 105, DECATUR, IL, 62521-3800

✓ 9-Digit EDI 837 ZIP+4 (62521-3800)

Practice Phone & Referral Fax

(217) 422-6100

Fax: (833) 784-5326

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1912985185 (THEODORE REXFORD ADDAI, 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

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1912985185` (NPI-1 Individual Practitioner)
Provider / Legal Name	THEODORE REXFORD ADDAI, M.D.
Plain-English Specialty	Board-Certified Cardiologist (Heart & Blood Vessel Specialist) NUCC Code: `207RC0000X` (Internal Medicine, Cardiovascular Disease)
Certifying / Licensing Body	American Board of Internal Medicine — Cardiovascular Disease
Practice Location Address	1770 E LAKE SHORE DR STE 105, DECATUR, IL, 62521-3800
Practice Telephone / Fax	Tel: (217) 422-6100 \| Fax: (833) 784-5326
Administrative Mailing Address	1770 E LAKE SHORE DR STE 105, DECATUR, IL, 62521-3800
Enumeration & Last Sync	Enumerated: 2006-01-06 \| CMS Record Updated: 2021-12-20

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1770 E LAKE SHORE DR STE 105, DECATUR, IL, 62521-3800

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Plain-English Taxonomy & CMS Crosswalk (207RC0000X)

What Does Taxonomy Code 207RC0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RC0000X translates to:
"Board-Certified Cardiologist (Heart & Blood Vessel Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 06 (Physician/Cardiovascular Disease (Cardiology)) • CMS Code 11 (Physician/Internal Medicine)
Certifying / Accrediting Authority: American Board of Internal Medicine — Cardiovascular Disease
Clinical Scope: Chest pain (angina), palpitations, atrial fibrillation, heart murmurs, shortness of breath on exertion, resistant hypertension, or post-heart attack care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (THEODORE REXFORD ADDAI, M.D.)

Typical CPT / Diagnostic Procedures:

Transthoracic Doppler Echocardiography (TTE — CPT 93306)
12-Lead Electrocardiogram (ECG) & Holter / Event Arrhythmia Monitoring
Exercise Treadmill & Myocardial Perfusion Nuclear Stress Testing
Diagnostic Coronary Angiography & Percutaneous Coronary Intervention (PCI)

Common Therapeutic Classes:

High-Intensity Statins (Atorvastatin, Rosuvastatin) & Ezetimibe
Beta-Blockers (Metoprolol Succinate, Carvedilol, Bisoprolol)
Sacubitril/Valsartan, Empagliflozin & Spironolactone (Heart Failure GDMT)
Apixaban, Rivaroxaban & Clopidogrel (Atrial Fibrillation & Stent Thrombosis Prevention)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`174400000X` — Specialist Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: IL \| License: `036078026` \| Primary: Secondary
`207RC0000X` — Internal Medicine, Cardiovascular Disease Plain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist)	State: IL \| License: `036078026` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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THEODORE REXFORD ADDAI, M.D. (NPI #1912985185)