Provider Enrollment: Eliminate Development Request for Additional Information

To eliminate requests for additional information and documentation on provider enrollment applications, ensure all necessary actions are complete before submission.

• Verify the NPI legal name in NPPES matches the SSA office for individuals and/or the IRS document for entities.
• Complete all fields on the CMS-588 form and attach a voided check or bank confirmation letter (if applicable).
• Application Fee: Certified institutional providers and select certified Part B entities, must pay an application fee for initial enrollment, revalidation or adding a new practice location. Use the Medicare Provider Enrollment Application Fee Decision Tree Tool on our website for guidance.
• AO/DO Details: Complete the Individual Control section in PECOS or section 6 on the CMS-855 paper application with accurate and complete AO/DO information (e.g., Title, SSN, DOB, % ownership).
  • Hospice – must identify medical directors and administrators
  • SNF – must identify all organization and individual control information under Attachment 1, including medical directors and administrators
• Signatures on Applications:
  • Paper submissions, ensure appropriate authorized or delegated official signatures and dates are completed before mailing.
  • PECOS log in within 24 hours after submission to confirm all signatures are complete. If pending, according to signature method selected either upload a signed and dated certification statement or resend the e-signature email.
    • For guidance on verifying signatures in PECOS, visit our events web page and register for "PECOS: Manage Signatures and Additional Information Requests".

Required Supporting Documents (varies by application type):

• IRS Documentation
• DEA Certificate
• Voided Check/Bank Confirmation Letter with CMS-588
• Nonphysician Degree/Certification
• Exhibit 177 (FQHC only)
• Documentation Meeting Capitalization Requirements (HHAs only)
• Copies of Bills of Sale/Sales Agreements (CHOWs, Acquisitions/Mergers, Consolidations only)

Posted 5/14/2025