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One provider matched this enrollment ID.

Enrollment ID I20111020000081 resolves to a single NPI record. Open the full profile for complete detail.

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JR
NPI · 1164493391 · Active
John Rubsam O.D.
Optometrist · Branford, Connecticut
Active
NPI
1164493391
Enrollment ID
I20111020000081
Taxonomy
152W00000X
Type
Practitioner - Optometry

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

  • 090001022CT01CT· Issued by ANTHEM BLUE CROSS ID
  • 615076CT· Issued by CONNECTICARE ID
  • OV1151CT· Issued by HEALTHNET OF CONN. ID
  • P1285753CT· Issued by OXFORD HEATH ID
  • 4419937CT· Issued by AETNA ID

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.