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Posting Date: 06/07/2021
Verify and Manage Signature(s)
Verify and Manage Signature(s) Verify signatures on all application(s) submitted including applications that were “Return for Corrections”, by returning to the enrollment box in PECOS. Important: The reassignments are viewed by selecting [...]
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Posting Date: 09/26/2023
Physicians or Nonphysician Practitioners With/Without Private Practice
Physicians or Nonphysician Practitioners With/Without Private Practice Download CMS-855I. Complete the CMS-855I section 1A by selecting “You are reporting a change to your Medicare enrollment information,” then in section 1B, check all that [...]
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Posting Date: 03/15/2021
Provider Clinics/Group Practices and Other Suppliers
Provider Clinics/Group Practices and Other Suppliers Download CMS-855B. Complete the CMS-855B section 1A by selecting “You are reporting a change to your Medicare enrollment Information,” then in section 1B, check all that apply and [...]
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Posting Date: 11/08/2019
Supporting Documents
Supporting Documents Attach required supporting documentation for individuals or organizations. Submit applicable documents. CMS-588 EFT Authorization Agreement and voided check or bank confirmation letter IRS document confirming your [...]
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