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Enrollment ID I20190619002089 resolves to a single NPI record. Open the full profile for complete detail.

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NPI · 1831194216 · Active
Rudolph Willis M.D.
Hematology & Oncology · Portsmouth, Virginia
Active
NPI
1831194216
Enrollment ID
I20190619002089
Taxonomy
207RH0003X
Type
Practitioner - Hospice/Palliative Care

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

  • 89067J2NC· Issued by NC MEDICAID
  • P00013926VA· Issued by RAILROAD MEDICARE
  • 437204VA· Issued by ANTHEM BCBS
  • 59557VA· Issued by OPTIMA HEALTH PLAN
  • 374935VA· Issued by MAMSI/MDIPA

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.