Failure to Report a Critical Change
Providers and suppliers enrolled in Medicare are required to ensure strict compliance with Medicare regulations by submitting updates and changes to enrollment information in accordance with specified timeframes pursuant to 42 CFR, Section 424.516.
Reportable changes include, but are not limited to, changes in:
- LBN
- TIN
- Practice location
- Ownership
- Authorized/delegated officials
- EFT account information
- Final adverse legal actions
- Felony convictions
- License suspensions or revocations
- Exclusion or debarment from participation in federal or state health care program
- Medicare revocation by a different Medicare contractor
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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
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