CMS-1500 Box 24J / 33a • NPI
1932187713
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207P00000X (CMS 93)
Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)
Box 32 Service Location & ZIP+4
3200 MACCORKLE AVE SE, CHARLESTON, WV, 25304-1227
✓ 9-Digit EDI 837 ZIP+4 (25304-1227)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1932187713 (SAM ABDUL, 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 #1932187713)
Medicare Beneficiaries
254
Total Billed Services
397
Distinct CPT/HCPCS Codes
16
Medicare Allowed Total
$48,234.31
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 61 |
99283 | Emergency department visit with low level of medical decision making | 17 |
99284 | Emergency department visit with moderate level of medical decision making | 123 |
99285 | Emergency department visit with high level of medical decision making | 145 |
99291 | Critical care, first 30-74 minutes | 28 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Azithromycin Azithromycin | 20 | 19 |
| Cephalexin Cephalexin | 15 | 15 |
| Doxycycline Hyclate Doxycycline Hyclate | 33 | 33 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 45 | 45 |
| Nitrofurantoin Mono-Macro Nitrofurantoin Monohyd/M-Cryst | 11 | 11 |
| Prednisone Prednisone | 52 | 50 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1932187713 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SAM ABDUL, MD |
| Plain-English Specialty | Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: 207P00000X (Emergency Medicine) |
| Certifying / Licensing Body | American Board of Emergency Medicine (ABEM) |
| Practice Location Address | 3200 MACCORKLE AVE SE, CHARLESTON, WV, 25304-1227 |
| Practice Telephone / Fax | Tel: (304) 388-4170 |
| Administrative Mailing Address | 4750 HEMPSTEAD STATION DR, KETTERING, OH, 45429-5164 |
| Enumeration & Last Sync | Enumerated: 2006-01-03 | CMS Record Updated: 2023-08-16 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207P00000X)
What Does Taxonomy Code 207P00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207P00000X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SAM ABDUL, MD)
Typical CPT / Diagnostic Procedures:- Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
- Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
- Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting
- Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
- Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
- Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: WV | License: 20404 | Primary: Secondary |
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: MI | License: 4301088857 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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