One provider matched this enrollment ID.
Enrollment ID I20090420000079 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 3 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
- I20090420000079Nurse PractitionerVA
- I20190826000564Nurse PractitionerTX
- I20240221003910Nurse PractitionerAK
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
- 541586601118VA· Issued by TRICARE/CHAMPUS
- P01051629VA· Issued by RAILROAD MEDICARE
- 1922246503VA· Issued by VA PREMIER
- 1922246503VA· Issued by AETNA
- 1922246503VA· Issued by ANTHEM MEDIGAP
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.