One provider matched this enrollment ID.
Enrollment ID I20040802000855 resolves to a single NPI record. Open the full profile for complete detail.
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
- I20040802000855Diagnostic RadiologyPA
- I20170308000248Diagnostic RadiologyNJ
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
- 0509987000PA· Issued by KEYSTONE HMO
- DA676496PA· Issued by BCBS
- 61379901MD· Issued by BLUE CROSS/BLUE SHIELD MD
- 300103158PA· Issued by RAILROAD MEDICARE
- 300129623MD· Issued by RAILROAD MEDICARE
- 1115837PA· Issued by KEYSTONE HEALTH PLAN
- E89145MD· Issued by TRICARE
- 1190944605MD· Issued by OWCP
- 3977180PA· Issued by AETNA
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.