One provider matched this enrollment ID.
Enrollment ID I20040302000331 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds a Medicare enrollment 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
- I20040302000331Physician AssistantSD
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.
Medicaid
- 352157500MN
- 12200ND
- 46022474352NE
- 3148379IA
- 6825460SD
Other
- 9238091SD· Issued by DAKOTACARE
- 040121002MN· Issued by PRIMEWEST
- 30791SD· Issued by SANFORD HEALTH PLAN
- 241L9OEMN· Issued by CC SYSTEMS/ BLUE PLUS
- 57108C027SD· Issued by WPS TRICARE
- 1931128SD· Issued by ARAZ/ AMERICA'S PPO
- 370624200SD· Issued by DEPT OF LABOR
- 241098SD· Issued by MIDLANDS CHOICE
- 412991034954SD· Issued by PREFERRED ONE
- 4995860SD· Issued by BLUE CROSS
- HP39461SD· Issued by HEALTHPARTNERS
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.