One provider matched this Medicaid ID.
California Medicaid ID LAB79751F 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
Other
- 05D0679751CA· Issued by CLIA NUMBER
- 05D2230383CA· Issued by CLIA
Source: NPPES public registry.
Medicare enrollment
This provider holds 9 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
- O20051026000145Portable X-Ray SupplierCA
- O20141215000138Clinic/Group PracticeTX
- O20141219000804Clinic/Group PracticeHI
- O20150105000845Clinic/Group PracticeDC
- O20150106000920Clinic/Group PracticeIL
- O20150114001629Clinic/Group PracticeNY
- O20150224001133Clinic/Group PracticeFL
- O20150311001368Clinic/Group PracticeGA
- O20161007000118Clinic/Group PracticeNJ
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.