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Medicare enrollment lookup

One provider matched this enrollment ID.

Enrollment ID I20070222000484 resolves to a single NPI record. Open the full profile for complete detail.

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JW
NPI · 1477639219 · Active
Jennifer Wilson DO
Family Medicine · Chandler, Texas
Active
NPI
1477639219
Enrollment ID
I20070222000484
Taxonomy
207Q00000X
Type
Practitioner - Family Practice

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

  • 75-2616977-041TX· Issued by TRICARE
  • 8CW412TX· Issued by BCBS
  • P00967753TX· Issued by MEDICARE RR
  • 75-2616977-007TX· Issued by TRICARE DOUGLAS
  • 752616977002TX· Issued by TRICARE
  • P00385523TX· Issued by TC GROUP CR1017

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.