One provider matched this Medicaid ID.
New Mexico Medicaid ID 88730336 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
- 9651706· Issued by AETNA PROVIDER NUMBER
- A103068CA· Issued by MEDICAL BOARD LICENSE
- 12205977CA· Issued by CAQH PROVIDER NUMBER
Medicaid
- 88730336NM
Source: NPPES public registry.
Medicare enrollment
This provider holds 2 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
- I20120914000654Physical Medicine and RehabilitationCO
- I20151210001092Pain ManagementNM
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.