Submit Enrollment Application

Revalidate Enrollment In PECOS

Instructions for accessing and submitting existing enrollment information in Provider Enrollment, Chain and Ownership System (PECOS):

  • Login to PECOS
  • Select My Associates
  • Scroll down under Existing Associates
  • Select ”View Enrollment” for applicable enrollment
  • Select applicable enrollment record under Existing Enrollments
  • Select Revalidate
  • Confirm reason for application
  • Select “Start Application”
  • Review and update appropriate “Topic View” section(s)
  • Upload supporting documents (if applicable)
  • Resolve all errors and verify warnings
  • Select “Begin Submission”
  • Proceed with the Electronic Signature or Upload Certification Process
  • Review and agree to Medicare regulations (Read and answer Attestation questions, if applicable)
  • Verify National Government Services as your contractor
  • Complete Submission button must be clicked to finish application
  • Print and/or save your submission confirmation and tracking number

Related Content

Reviewed 7/30/2024

Helpful Resources

Check Provider Enrollment Application Status
Log Into PECOS
Pay Application Fee

J6 Mailing Address:

National Government Services, Inc.
P.O. Box 6475
Indianapolis, IN 46206-6475

Interactive Voice Response:

877-908-9499

Contact Enrollment:

877-908-8476

Hours Available:

Monday–Friday
8:00 a.m.–4:00 p.m. CT

Form(s) you'll need:

Enrollment Forms

Helpful Resources

Check Provider Enrollment Application Status
Log Into PECOS
Pay Application Fee

JK Mailing Address:

National Government Services, Inc.
P.O. Box 7149
Indianapolis, IN 46207-7149

Interactive Voice Response:

877-869-6504

Contact Enrollment:

888-379-3807

Hours Available:

Monday–Friday
8:00 a.m.–4:00 p.m. ET

Form(s) you'll need:

Enrollment Forms