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One provider matched this enrollment ID.

Enrollment ID I20040311001255 resolves to a single NPI record. Open the full profile for complete detail.

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NPI · 1558394320 · Active
Maryam Broukhim M.D.
Specialist · Great Neck, New York
Active
NPI
1558394320
Enrollment ID
I20040311001255
Taxonomy
174400000X
Type
Practitioner - General Surgery

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

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

Other

  • 03840ANY· Issued by GHI MEDICARE

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.