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Enrollment ID I20040407000883 resolves to a single NPI record. Open the full profile for complete detail.

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JS
NPI · 1225029556 · Active
John Soderling OD
Optometrist · Greenville, Kentucky
Active
NPI
1225029556
Enrollment ID
I20040407000883
Taxonomy
152W00000X
Type
Practitioner - Optometry

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.

Other

  • 21435· Issued by AVESIS
  • 25125· Issued by GE
  • P00107376· Issued by RAILROAD MEDICARE
  • 297436· Issued by OPTICHOICE
  • DB4678· Issued by RAILROAD MEDICARE GROUP
  • KY1281· Issued by EYEMED
  • 180034· Issued by NVA

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.