One provider matched this enrollment ID.
Enrollment ID I20040109001072 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 2 Medicare enrollments on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.
Practitioner
- I20040109001072Internal MedicinePA
- I20211018000031Internal MedicineNJ
Source: CMS PECOS public enrollment file.
Secondary identifiers
Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.
Other
- 0045722000PA· Issued by IBC - PC/KHPE
- 0019255PA· Issued by AETNA HMO
- 30010610PA· Issued by KEYSTONE MERCY
- 68800PA· Issued by FIRST HEALTH
- 025666PA· Issued by HIGHMARK BLUE SHIELD
- 1235185PA· Issued by CIGNA HMO/PPO
- P00064588PA· Issued by RRM
- 0045722000PA· Issued by AMERIHEALTH/INTERCOUNTY
- 113664PA· Issued by PHCS
- 4100033PA· Issued by AETNA PPO
- 10925258PA· Issued by CAQH ID #
Medicaid
Source: NPPES public registry.
ReferenceAbout Medicare Enrollment IDs
A Medicare Enrollment ID (ENRLMT_ID) is a 15-character public identifier assigned by the CMS Provider Enrollment, Chain and Ownership System (PECOS) when a provider, supplier, or organisation enrols in Medicare. Each row reflects one enrolment record: a single NPI can hold multiple enrolments across provider types, states, or supplier categories. Data here is mirrored from the quarterly public PECOS enrolment file published on data.cms.gov.