One provider matched this enrollment ID.
Enrollment ID I20161117000643 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
- I20161117000643Family PracticeMN
- I20170824003206HospitalistMN
- I20200423000537Internal MedicineWI
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
- 1467898718MN· Issued by BCBS
- 0001-0117027· Issued by MEDICA
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.