The Medicare Provider Enrollment department is dedicated to providing you with quality service.  Processing an eligible Medicare provider/supplier application requires extensive research to insure all information provided is accurate and all appropriate attachments are supplied.  Absent extenuating circumstances, the processing time for Medicare application forms, CMS 855I, and CMS 855B must be within 60 calendar days of receipt into our department.   The CMS 855R and any changes must be processed within 45 calendar days of receipt.

  • CMS Enrollment Website – Provider/Suppliers can view current CMS Enrollment Information directly from the following location. The web site will provide the most current CMS Provider Enrollment information, forms and commonly asked questions.

Top Reasons for Development 

  • Contact person signs section 6A instead of AO/DO
  • Section 15, section 4A and/or 4B missing either signature or date
  • Section 3 Adverse Legal not completed
  • Section 1 missing individual NPI and PTAN
  • Section 2 missing SSN
  • Correct AO/DO signatures
  • Clarify purpose because Section 1 incomplete
  • 855I section 4 , missing group name, NPI and PTAN
  • 855B, section 4, practice location information
  • CMS 588 EFT form along with preprinted voided check or letter from bank
  • Incomplete apps in PECOS. PECOS PI should indicate 100% complete
  • Type 2 NPI and CP575 for sole owners who are incorporated (PA, LLC, INC, PLLC)
  • Payment of Application Fee for suppliers


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