One provider matched this enrollment ID.
Enrollment ID I20040702000569 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
- I20040702000569Family PracticeMO
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
- 220317MO· Issued by BLUE CROSS BLUE SHIELD
- 4664266· Issued by AETNA
- 324300· Issued by GROUP HEALTH PLAN
- P00141251· Issued by MEDICARE RAILROAD
- 992574· Issued by UNITED HEALTH CARE
- 175369MO· Issued by HEALTHLINK
- S92007· Issued by EXCLUSIVE CHOICE
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.