Target audience: Medicare fee-for-service providers

Use the links on the left to navigate through the various sections of this user guide. 

The provider enrollment gateway can be used as a secure mechanism for providers and suppliers to: 

• Upload paper enrollment applications
• Submit responses to development requests for an application submitted through the gateway
• Request a copy of enrollment correspondence for a paper application submitted through the gateway
• Check the status of a previously uploaded paper application submitted through the gateway

It also provides an alternative for providers and suppliers unable to utilize PECOS web or those that have automated processes for pre-populating paper enrollment applications from their credentialing databases. 

The gateway accepts only the following paper enrollment application types in PDF form:

• CMS-855A for Institutional Providers
• CMS-855B for Clinics/Group practices and Certain Other Suppliers

• CMS-855I for Physicians and Non-Physician Practitioners

• CMS-855O for Eligible Ordering and Referring Physicians and Non-physician Practitioners

• CMS-20134 for Medicare Diabetes Prevention Program Suppliers

• CMS-460 Medicare Participating Physician or Supplier Agreement

Note: The provider enrollment gateway will only accept the application types listed above. The provider enrollment gateway will reject the following stand-alone submissions that are not submitted as part of the PDF enrollment application package which include but are not limited to: 

• Electronic data interchange (EDI) applications
• Opt-out affidavits
• Appeals (corrective action plans (CAP), reconsiderations, or rebuttals)
• Miscellaneous correspondence

Please continue to send stand-alone non-enrollment applications via mail, fax, or email, as applicable.