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Medicare enrollment lookup

One provider matched this enrollment ID.

Enrollment ID I20041101001053 resolves to a single NPI record. Open the full profile for complete detail.

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JP
NPI · 1952399669 · Active
Juan Polo MD
Internal Medicine · Louisville, Kentucky
Active
NPI
1952399669
Enrollment ID
I20041101001053
Taxonomy
207R00000X
Type
Practitioner - Family Practice

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

  • 200489040IN· Issued by ANTHEM INDIANA MEDICAID- NORTON ICC
  • 200489040KY· Issued by MD WISE- NORTON ICC
  • 1128117KY· Issued by PASSPORT
  • 200489040KY· Issued by HEALTHY INDIANA PLAN- NORTON ICC
  • 31K4, 000000179689KY· Issued by ANTHEM
  • P00838101IN· Issued by RRMCR - NICC
  • 002045573-002· Issued by UNITED HEALTHCARE
  • 017376KY· Issued by SIHO - NORTON ICC
  • 5832707KY· Issued by AETNA
  • P00362331KY· Issued by RRMCR - NICC
  • 000000381954KY· Issued by ANTHEM - NORTON ICC

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.