- Determine if you will use PECOS or paper to enroll
- Enroll Using PECOS
-
Enroll Using Paper
- Determine your Business Structure
- Individual (Group Member) Reassigning Benefits Only
- Individual Medicare Enrollment Private Practice (Sole Proprietor) via SSN
- Individual Medicare Enrollment Private Practice (Sole Proprietor) via EIN
- Individual Medicare Enrollment Sole Owner of a Corporation via Tax ID
- Physician Assistant
- New Provider Corporation or Group (Multiple Owners)
- Ordering/Referring Provider Only
- Adding a New Reassignment of Benefits Using the CMS-855I
- Electronic Funds Transfer Agreement
- Medicare Participating Physician or Supplier Agreement
- Supporting Documents
Determine your Business Structure
When starting a business, you must decide what form of business entity you wish to establish.
The legal structure you choose for your business has more to do with tax, liability and management arrangements.
Reviewed 6/13/2024
Helpful Resources
Check Provider Enrollment Application Status
Log Into PECOS
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:
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:
Helpful Resources
Check Provider Enrollment Application Status
Log Into PECOS
J6 Mailing Address:
National Government Services, Inc.
P.O. Box 6474
Indianapolis, IN 46206-6474
Contact Enrollment:
855-834-5596
Hours Available:
Monday–Friday
8:00 a.m.–4:00 p.m. CT
9:00 a.m.–5:00 p.m. ET
*Closed for training on the 2nd and 4th Friday of the month
12:00 p.m.-4:00 p.m. ET
11:00 a.m.-3:00 p.m. CT
Form(s) you'll need:
CMS-855A - Medicare Enrollment Application form for Institutional Providers
CMS-588 - Electronic Funds Transfer (EFT) Authorization Agreement form
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 46206-7149
Contact Enrollment:
855-593-8047
Hours Available:
Monday–Friday
8:00 a.m.–4:00 p.m. ET
*Closed for training on the 2nd and 4th Friday of the month
12:00 p.m.-4:00 p.m. ET
Form(s) you'll need:
CMS-855A - Medicare Enrollment Application form for Institutional Providers
CMS-588 - Electronic Funds Transfer (EFT) Authorization Agreement form