One provider matched this enrollment ID.
Enrollment ID O20040402000810 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 4 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.
Part B Supplier
- O20040325001333Clinic/Group PracticeSD
- O20040402000810Clinic/Group PracticeIA
- O20060822000043Clinic/Group PracticeMN
DME Supplier
- O20100930037880Physician - OphthalmologySD
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
- 25529IA· Issued by WELMARK OF IA
- 0000131SD· Issued by BLUE SHIELD SD
- 121854D375MN· Issued by UCARE MN
- 91128OPMN· Issued by BLUE SHIELD MN
- 68A69OPMN· Issued by BLUE SHIELD MN
- 802S0OPMN· Issued by BLUE SHIELD MN
- 52223IA· Issued by WELLMARK OF IA
- 19431· Issued by HEALTHPARTNERS
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.