Provider Enrollment - New Providers

Providers must enroll in the Medicare program in order to receive Medicare payment for services provided to its beneficiaries. The enrollment process begins by completing and submitting a CMS-855A application. The application is utilized to gather information about your entity and verify eligibility for enrollment into the Medicare program. For more information visit the CMS web site.

• Provider Enrollment Forms Assistant Page | Provider Enrollment FAQs Forms Assistant | Provider Enrollment Reference Guide
• Acronyms and Abbreviations
• Electronic Funds Transfer (EFT) Information | EFT mailing instructions
• Information and Education Resources for Medicare Providers, Suppliers, and Physician
• For additional enrollment information please refer to the CMS Medicare Fee-For-Service Provider/Supplier Enrollment Web Site
• Please Note: You may download the current version of the CMS Medicare Provider Enrollment Application (CMS-855A)
• Provider Enrollment Reminder

If your health care organization is part of the Beverly chain and Total Renal Care/Davita, please contact our Camarillo office.

If your organization is a Federally Qualified Health Center, and you are not hospital based, National Government Services, Inc will be your fiscal intermediary. National Government Services, Inc is responsible for all freestanding FQHCs.

Effective July 1, 2006, contact our Camarillo office if you are located in the states of:

• California
• Nevada
• Hawaii

Please contact our Milwaukee office for all other states.

For Certified/Overnight Mail