One provider matched this Medicaid ID.
Missouri Medicaid ID 200076359 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
- 26D0446923MO· Issued by CLIA (TCMH)
Source: NPPES public registry.
Medicare enrollment
This provider holds 8 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
- I20151111000393Internal MedicineAR
- I20230511002634Family PracticeMO
- I20231026001764Emergency MedicineIL
- I20231026004376Emergency MedicineAZ
- I20231101000316Family PracticeKS
- I20240207000626Emergency MedicineOK
- I20250108000574Emergency MedicineTX
- I20250430003189Family PracticeAL
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.