Read the request carefully. If clarification is needed, contact the provider enrollment representative processing the application. The name and phone number will be listed on the request. 

Log into PECOS, find the submitted enrollment under existing enrollments (IF a reassignment is involved, click View/Manage Reassignment) > then select correct and resubmit button > make updates or upload supporting documents and submit completed application.

Tips:

• To change the physician primary or secondary specialty, select Practitioner Specialty topic.
• To change the nonphysician specialty, submit an initial enrollment to establish a new specialty.
• To change from a physician to a nonphysician specialty or vice versa, submit an initial enrollment to establish a new specialty.
• To process the reassignment application when provider is new to Medicare or new to the group’s state, creatte and submit an initial enrollment for the individual.

More information: PECOS Starter Guide and PECOS Correct and Resubmit Application Instructions.