One provider matched this Medicaid ID.
Texas Medicaid ID 080463501 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 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.
Practitioner
- I20041105000889Family PracticeTX
- I20221206001686Family PracticeWA
- I20221219001926Family PracticeAZ
- I20230818000405Family PracticeMO
- I20231117002335Family PracticeOK
- I20240119000524Family PracticeIL
- I20240221003320Family PracticeTN
- I20240826000293Family PracticeCO
- I20250815002493Family PracticeWY
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.