One provider matched this Medicaid ID.
Massachusetts Medicaid ID 9728601 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.
Source: NPPES public registry.
Medicare enrollment
This provider holds 25 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
- O20040731000004Clinic/Group PracticeMA
- O20210830000339Clinic/Group PracticeNY
- O20210903000999Clinic/Group PracticeNJ
- O20220118001102Clinic/Group PracticeFL
- O20251218002327Clinic/Group PracticeOK
- O20251218002760Clinic/Group PracticeCO
- O20251219002214Clinic/Group PracticeMD
- O20251219002402Clinic/Group PracticePA
- O20251219003280Clinic/Group PracticeOH
- O20251223000703Clinic/Group PracticeWA
- O20251223001195Clinic/Group PracticeWI
- O20251223001302Clinic/Group PracticeNV
- O20251223003231Clinic/Group PracticeCA
- O20251223003828Clinic/Group PracticeHI
- O20251224000925Clinic/Group PracticeTN
- O20251224001343Clinic/Group PracticeAK
- O20251224001363Clinic/Group PracticeOR
- O20251224001879Clinic/Group PracticeAZ
- O20251230002436Clinic/Group PracticeTX
- O20260105003119Clinic/Group PracticeGA
- O20260108002690Clinic/Group PracticeNC
- O20260115002639Clinic/Group PracticeMO
- O20260120001694Clinic/Group PracticeNH
- O20260120002386Clinic/Group PracticeCT
- O20260123001283Clinic/Group PracticeMI
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.