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Medicare enrollment lookup

One provider matched this enrollment ID.

Enrollment ID I20200417001020 resolves to a single NPI record. Open the full profile for complete detail.

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TB
NPI · 1407911381 · Active
Tiffani Bacon Pt, Dpt
Physical Therapist · San Diego, California
Active
NPI
1407911381
Enrollment ID
I20200417001020
Taxonomy
225100000X
Type
Practitioner - Physical Therapist In Private Practice

Medicare enrollment

This provider holds 2 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

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

  • P00405932· Issued by RAILROAD MEDICARE
  • CP039211T-MDMD· Issued by COMPACT PT LICENSURE

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.