One provider matched this enrollment ID.
Enrollment ID I20211012000488 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 11 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
- I20131015001411Family PracticeNY
- I20211012000488Family PracticeGA
- I20220224001696Family PracticeCA
- I20220303001222Family PracticeMI
- I20220317002587Family PracticeNM
- I20220323001813Family PracticeOH
- I20240123000779Family PracticeMN
- I20240918002574Family PracticeIN
- I20241217000317Internal MedicineMS
- I20241217000502Internal MedicineLA
- I20250424002959Family PracticeCT
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
- 03760574NY
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.