Submit Enrollment Application

PECOS Enrollment Process and Advantages

The Internet-based PECOS can be used in lieu of the paper enrollment application.

Submitting the application via PECOS is the preferred method.

Advantages include:

  • Faster application process
  • Automatic selection of proper enrollment form(s)
  • Tailored application process
  • Fewer submission errors/omissions

This system allows you to securely review information currently on file, update and submit via the Internet.

Important: PECOS has two separate enrollment records for sole owners, the group enrollment and the individual enrollment. When submitting a change of information or revalidation verify and update (when applicable), the information on both enrollments.

Related Content

Helpful Resources

Check Provider Enrollment Application Status
Log Into PECOS
Pay Application Fee

J6 Mailing Address:

National Government Services, Inc.
P.O. Box 6475
Indianapolis, IN 46206-6475

Interactive Voice Response:

877-908-9499

Contact Enrollment:

877-908-8476

Hours Available:

Monday–Friday
8:00 a.m.–4:00 p.m. CT

Form(s) you'll need:

Enrollment Forms

Helpful Resources

Check Provider Enrollment Application Status
Log Into PECOS
Pay Application Fee

JK Mailing Address:

National Government Services, Inc.
P.O. Box 7149
Indianapolis, IN 46207-7149

Interactive Voice Response:

877-869-6504

Contact Enrollment:

888-379-3807

Hours Available:

Monday–Friday
8:00 a.m.–4:00 p.m. ET

Form(s) you'll need:

Enrollment Forms