Skip to Main Content
 
 
 
Web Content Viewer

Enrollment

Web Content Viewer
Revalidate My Enrollment
Revalidate My Enrollment

Revalidate My Enrollment


Best Practices for Revalidating Your Enrollment

  • Take advantage of PECOS to complete your enrollment application
  • Respond to the revalidation request by the due date on the request
  • If not e-signing, remember to mail the signed and dated certification statement(s)
  • Be sure to pay the application fee or submit a hardship request
  • Verify that you are using the correct version of the CMS-855 (07/11)
  • Verify that you are using the correct version of the CMS-588 (01/17)
  • Ensure that your application is complete and that all supporting documentation is included
  • Ensure that the Legal Business Name entered in section 2 matches the name located on your IRS tax documentation
  • Respond quickly to any request for additional information or changes required to process your application
  • Ensure the application is signed by an authorized official and dated
  • Be sure to enter your Medicare identification number (if issued) and the NPI you would like to link to this number in Section 4
Last Modified: 2/11/19

Check Provider Enrollment Application Status

Learn About PECOS Web!

J6 Mailing Address:

National Government Services, Inc.

P.O. Box 6474 | Indianapolis, IN 46206-6474

JK Mailing Address:

National Government Services, Inc.

P.O. Box 7149 | Indianapolis, IN 46207-7149

Contact Enrollment:

J6: 855-834-5596

JK: 855-593-8047

Available by phone Monday-Friday*
JK: 8:00 a.m.-4:00 p.m. ET
J6: 8:00 a.m.-4:00 p.m. CT
J6: 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

Complementary Content