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Medicare enrollment lookup

One provider matched this enrollment ID.

Enrollment ID O20171012000577 resolves to a single NPI record. Open the full profile for complete detail.

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RR
NPI · 1619403854 · Active
Rita R Ellithorpe MD, INC
Prevention Professional · Tustin, California
Active
NPI
1619403854
Enrollment ID
O20171012000577
Taxonomy
405300000X
Type
Part B Supplier - Clinic/Group Practice

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

Source: CMS PECOS public enrollment file.

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.