One provider matched this enrollment ID.
Enrollment ID I20171002003709 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 16 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
- I20050901000604Interventional CardiologyVA
- I20111101000524Cardiovascular Disease (Cardiology)OK
- I20170130000865Interventional CardiologyIL
- I20171002003709Interventional CardiologyKY
- I20180228002523Cardiovascular Disease (Cardiology)TX
- I20190212000962Cardiovascular Disease (Cardiology)OR
- I20200714001338Cardiovascular Disease (Cardiology)WV
- I20210405001194Interventional CardiologyNC
- I20210407002886Interventional CardiologyAK
- I20230206000761Internal MedicineWI
- I20230614003587Interventional CardiologyGA
- I20240214004017Interventional CardiologyWA
- I20240627002592Interventional RadiologyNM
- I20241125004066Cardiovascular Disease (Cardiology)MI
- I20250212002409Cardiovascular Disease (Cardiology)ME
- I20250507000590Internal MedicinePA
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
- P00803509· Issued by RAILROAD MEDICARE TO GRP DN7755
Medicaid
- 2173473WA
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.