One provider matched this Medicaid ID.
Missouri Medicaid ID 205477201 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.
Other
- 008131IL· Issued by HEALTH ALLIANCE PROVIDER
- 37773· Issued by PHCS
- 37893· Issued by TRICARE
- 228074· Issued by HEALTHLINK
- 036075454000· Issued by OSF HEALTH PLANS
- 05732036IL· Issued by BLUE SHIELD GROUP NUMBER
- 233989· Issued by PERSONAL CARE
- 1955270· Issued by UNITED HEALTHCARE
- IL0102· Issued by JOHN DEERE HEALTH PLAN
Medicaid
Source: NPPES public registry.
Medicare enrollment
This provider holds a Medicare enrollment 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
- I20060830000130Thoracic SurgeryIL
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.