Enrollment
Tools & forms: Enrollment
Use these self-service tools and forms to enroll as a Medicare provider or make changes to an existing enrollment record.
Tools & forms: Enrollment
Use these self-service tools and forms to enroll as a Medicare provider or make changes to an existing enrollment record.
Transplant programs
Read this information regarding adding a transplant program to a hospital enrollment record.
Provider enrollment effective dates
Review this article for information on provider enrollment effective dates.
Provider enrollment effective dates
Review this article for information on provider enrollment effective dates.
How do I voluntarily terminate or deactivate my Medicare enrollment?
Submit the applicable CMS-855 application to voluntarily terminate your Medicare enrollment or to deactivate your reassignment. Review this article to learn more.
Reporting requirements for a legal business name (LBN) change
Changes to the legal name or LBN must be reported to the Medicare contractor within 90 days. Review this article to learn more.
Reporting requirements for a legal business name (LBN) change
Changes to the legal name or LBN must be reported to the Medicare contractor within 90 days. Review this article to learn more.
How do I voluntarily terminate or deactivate my Medicare enrollment?
Submit the applicable CMS-855 application to voluntarily terminate your Medicare enrollment or to deactivate your reassignment. Review this article to learn more.
How to change or add a practice mailing address
All changes of practice addresses are reported on the applicable CMS-855 form. Find out what form is right for you.