One provider matched this Medicaid ID.
California Medicaid ID 0AX764900 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
Source: NPPES public registry.
Medicare enrollment
This provider holds 14 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
- I20101011000975Internal MedicineCA
- I20231110001812Internal MedicineMS
- I20240306003934Internal MedicineIL
- I20240307003762Internal MedicineNY
- I20240313004363Internal MedicineNC
- I20240416003214Internal MedicineAZ
- I20241224001529Internal MedicineCT
- I20250106003581Internal MedicineNH
- I20250107000033Internal MedicineWI
- I20250207000219Internal MedicineRI
- I20250207000709Internal MedicineMA
- I20250217000944Internal MedicineMN
- I20250217001051Internal MedicineGA
- I20250409002602Internal MedicineOH
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.