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Medicare enrollment lookup

One provider matched this enrollment ID.

Enrollment ID I20160129001050 resolves to a single NPI record. Open the full profile for complete detail.

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GD
NPI · 1053759738 · Active
Grace De La Cruz PA-C
Physician Assistant · Clark, New Jersey
Active
NPI
1053759738
Enrollment ID
I20160129001050
Taxonomy
363A00000X
Type
Practitioner - Physician Assistant

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.

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.