One provider matched this Medicaid ID.
Arizona Medicaid ID 809379 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.
Medicaid
- 809379AZ
Other
- 03-31815· Issued by MEDICARE
- ZFQ31815· Issued by MEDICARE
Source: NPPES public registry.
Medicare enrollment
This provider holds 6 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
- I20111110000009Family PracticeAZ
- I20220316002601Family PracticeCO
- I20220531000423Family PracticeKS
- I20220822001117Family PracticeMO
- I20221010001348Family PracticeNM
- I20221213002709Family PracticeWY
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.