- Description of NPI and a Link to NPPES Registry
- State License and Registrations for Certified Providers and Suppliers
- Eligible Institutional Providers
- Eligible Part B Physicians and Nonphysicians to Enroll as Ordering and Referring Only
- Eligible Method II Providers
- Certified Provider and State Survey Agency
- Understanding the Approval Recommendation Process for Certified Providers
- Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
- Understanding Authorized Official and Delegated Official Roles
Certified Provider and State Survey Agency
Table of Contents
Certified Provider and State Survey Agency
In addition to completing and submitting the Medicare enrollment applications, the certified provider must meet all federal requirements. The State Survey Agency can provide precertification assistance.
Prospective provider/supplier must contact the SA for certification materials for their provider/supplier type. If the applicant has not contacted the SA before the SA receives the MAC's recommendation for approval, it will delay the enrollment process.
Contact the SA as soon as a decision is made to enroll with Medicare or make a change to the Medicare information!
Certified Providers/Suppliers
View Centers for Medicare & Medicaid Services (CMS) Internet-only-Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 10 (sections listed below) for additional information on certified provider/suppliers.
Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A
10.2.1.1 Community Mental Health Centers (CMHCs)
10.2.1.2 Comprehensive Outpatient Rehabilitation Facilities (CORFs)
10.2.1.3 End-Stage Renal Disease Facilities (ESRDs)
10.2.1.4 Federally Qualified Health Centers (FQHCs)
10.2.1.5 Histocompatibility Laboratories
10.2.1.6 Home Health Agencies (HHAs)
10.2.1.7 Hospices
10.2.1.8 Hospitals and Hospital Units
10.2.1.9 Indian Health Services (IHS) Facilities
10.2.1.10 Organ Procurement Organizations (OPOs)
10.2.1.11 Outpatient Physical Therapy/Outpatient Speech Pathology
10.2.1.12 Religious Non-Medical Health Care Institutions (RNHCIs)
10.2.1.13 Rural Health Clinics (RHCs)
10.2.1.14 Skilled Nursing Facilities (SNFs)
Certified Suppliers That Enroll Via the Form CMS-855B
10.2.2.1 Ambulatory Surgical Centers (ASCs)
10.2.2.3 Independent Clinical Laboratory Improvement Act (CLIA) Labs
10.2.2.8 Portable X-Ray Suppliers (PXRSs)
Related Content
Revised 2/9/2023
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
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