To submit an application for a new provider, new to Medicare or new to the state, log into PECOS select “My Associates” button > “Create Initial Enrollment Application” button > select provider from list. If the provider is not listed, you will need to go to the I&A system to gain access to that providers record. (Link to Quick Reference Guide, page 31 or page 40)

To submit a change or revalidation application for a provider, that is actively enrolled in Medicare in the state, log into PECOS > select “My Associates” button > under Existing Associates select the “View Enrollment” button beside the providers name > scroll under Existing Enrollments for the appropriate enrollment record. If the provider is not listed, you will need to go to the I&A system to gain access to that providers record. (Link to Quick Reference Guide, page 31 or page 40).

More Information: Learn About PECOS Web and PECOS Starter Guide.