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One provider matched this enrollment ID.

Enrollment ID I20040407000303 resolves to a single NPI record. Open the full profile for complete detail.

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NPI · 1215984224 · Active
Justin Schroeder O.D.
Vision Therapy Optometrist · Caruthersville, Missouri
Active
NPI
1215984224
Enrollment ID
I20040407000303
Taxonomy
152WV0400X
Type
Practitioner - Optometry

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

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

  • 150674TN· Issued by BETTER HEALTH
  • 4067790TN· Issued by BLUE CROSS BLUE SHIELD TN
  • 0797303TN· Issued by CIGNA

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.