One provider matched this enrollment ID.
Enrollment ID O20211117001091 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 17 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
- O20031106000638Clinic/Group PracticeTN
- O20200225000283Clinic/Group PracticeSC
- O20200519001605Clinic/Group PracticeVA
- O20211109001755Clinic/Group PracticeKY
- O20211117001091Clinic/Group PracticeMS
- O20220321000732Clinic/Group PracticeAZ
- O20230322002852Clinic/Group PracticeCA
- O20240416002487Clinic/Group PracticeGA
- O20240425002151Clinic/Group PracticeAL
- O20240617000309Clinic/Group PracticeCO
- O20240621000969Clinic/Group PracticeNC
- O20241202001067Clinic/Group PracticeFL
- O20241230002731Clinic/Group PracticePA
- O20250102002357Clinic/Group PracticeIL
- O20250106002682Clinic/Group PracticeHI
- O20250116000821Clinic/Group PracticeTX
- O20250509001522Clinic/Group PracticeNY
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
- CD5029· Issued by PGBA (RR MEDICARE)
- 023464700· Issued by BLACK LUNG
- 242032VA· Issued by ANTHEM
- 373437500· Issued by DOL
- 1521046· Issued by UMWA
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.