One provider matched this enrollment ID.
Enrollment ID O20040130000960 resolves to a single NPI record. Open the full profile for complete detail.
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.
Part B Supplier
- O20040130000960Clinic/Group PracticeIA
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
- 5000126· Issued by UNITED HEALTHCARE
- DH0857IA· Issued by MEDICARE RR-PALMETTO GBA
- 21169IA· Issued by WELLMARK-CRNA
- 07244IA· Issued by WELLMARK-GSP
Medicaid
- 0474429IA
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.