One provider matched this enrollment ID.
Enrollment ID I20170628001048 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 7 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
- I20090721000297Diagnostic RadiologyNC
- I20100726000264Diagnostic RadiologyAL
- I20170628001048Diagnostic RadiologyTN
- I20240918002936Diagnostic RadiologyOK
- I20250422003303Diagnostic RadiologyDC
- I20250625003802Diagnostic RadiologyPA
- I20250930002383Diagnostic RadiologyIL
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
- 511-14270AL· Issued by BCBS
- 511-23742AL· Issued by BCBS
- 512-36120AL· Issued by BCBS
- 12368474· Issued by CAQH
- 511-04903AL· Issued by BCBS
- 511-04905AL· Issued by BCBS
- 511-04907AL· Issued by BCBS
- 511-07684AL· Issued by BCBS
- 512-05162AL· Issued by BCBS
- 512-36223AL· Issued by BCBS
- 511-04904AL· Issued by BCBS
- 511-04908AL· Issued by BCBS
- 511-14476AL· Issued by BCBS
- 4275439TN· Issued by BCBS
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.