One provider matched this enrollment ID.
Enrollment ID I20220119001211 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 14 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
- I20111228000386Physician AssistantPA
- I20140717002044Physician AssistantOH
- I20190918000814Physician AssistantIN
- I20200928001094Physician AssistantFL
- I20210122000554Physician AssistantMA
- I20220119001211Physician AssistantTX
- I20220630001665Physician AssistantNY
- I20220805000378Physician AssistantMI
- I20231107002878Physician AssistantDE
- I20240312003841Physician AssistantKY
- I20241206002449Physician AssistantNM
- I20250311001861Physician AssistantIL
- I20250404000255Physician AssistantNH
- I20250513002164Physician AssistantVA
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
- 965GA· Issued by GA STATE LICENSE
- MA055058PA· Issued by PA STATE LICENSE
- PA2023-0208NM· Issued by NM LICENSE
- PA3370KY· Issued by STATE LICENSE
- PA9106961FL· Issued by FL STATE LICENSE
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.