One provider matched this enrollment ID.
Enrollment ID I20051007000457 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 10 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
- I20051007000457Emergency MedicineWA
- I20161025002118Emergency MedicineMT
- I20170606001008Emergency MedicineID
- I20170619002206Emergency MedicineMD
- I20170901002697Addiction MedicineAK
- I20180108002726Emergency MedicineOR
- I20180712001984Addiction MedicineND
- I20191209001645Addiction MedicineDC
- I20200504002142Addiction MedicineAR
- I20210322002604Addiction MedicineNM
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
- 3074DAWA· Issued by BSWA
- 0202684WA· Issued by LIWA
Medicaid
- 8352197WA
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.