skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. Information for Medicare beneficiaries is only available on the website.
En Español
Text Size:
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 9/19/2018 Location: FL, PR, USVI Business: Part B

Sole proprietor versus a sole owner

Q: What are the differences in completing Section 4 of a CMS-855I application for a sole proprietor versus a sole owner?
A: Sole Proprietorship - Section 4F of the CMS-855I is completed with the employer identification number (EIN). The instructions in this section state, “if you are a sole proprietor and you want Medicare payments to be reported under your EIN, list it below.” Only one national provider identifier (NPI) number is needed for the provider. Sole proprietors do not complete section 4A.
Sole Ownership - Section 4A of the CMS-855I is completed with the tax identification number (TIN). If anything is listed in section 4A, a separate NPI number must be obtained for the group number that will be assigned and listed in section 4A. The individual’s NPI number and information must be listed in section 4C.
CMS recently made available a document that will assist physicians and non-physician practitioners in completing the CMS-855I form titled Medicare Provider Enrollment of Individuals (Physicians and Non-Physician Practitioners) external pdf file. Scenarios 2a, 2b, 3 & 4 are very helpful in determining if you are a sole proprietor or sole owner.
Source: The Centers for Medicare & Medicaid Services (CMS) internet-only manual (IOM) publication 100-08, chapter 15 external pdf file
list item Please use your browser's back button to return to the referring page.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.