One provider matched this Medicaid ID.
Arizona Medicaid ID 707482 resolves to a single NPI record. Open the full profile for complete detail.
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
- AW1436AZ· Issued by HEALTHNET GRP
- AZ0728670AZ· Issued by BLUE CROSS BLUE SHIELD GR
- 3981220AZ· Issued by EVERCARE GRP
Medicaid
- 707482AZ
Source: NPPES public registry.
Medicare enrollment
This provider holds 5 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
- I20040512000775Emergency MedicineAZ
- I20240619001077Emergency MedicineCA
- I20240807001388Emergency MedicineMS
- I20250617002052Emergency MedicineKS
- I20260112000716Emergency MedicineOK
Source: CMS PECOS public enrollment file.
ReferenceAbout state Medicaid identifiers
State Medicaid programmes assign each enrolled provider a state-scoped identifier used on Medicaid claims. The identifier is reported to the federal NPPES registry alongside the provider's NPI and is mirrored here from the public dissemination file. Each state administers its own Medicaid programme, so the same provider can hold different Medicaid numbers in different states.