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Medicare enrollment lookup

One provider matched this enrollment ID.

Enrollment ID I20120105000857 resolves to a single NPI record. Open the full profile for complete detail.

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BQ
NPI · 1215105630 · Active
Brett Qualls Pt
Physical Therapist · Lake Havasu City, Arizona
Active
NPI
1215105630
Enrollment ID
I20120105000857
Taxonomy
225100000X
Type
Practitioner - Physical Therapist In Private 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

  • 34485CA· Issued by CA LICENSE
  • 9575AZ· Issued by ARIZONA LICENSE
  • 2594NV· Issued by NV LICENSE

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.