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Last Modified: 2/3/2021 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 – In the CMS-855I, question three in section 4A 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 paid under your EIN, please check this box and fill in the EIB information below.” Only one NPI number is needed for the provider. Sole proprietors do not need to complete section 4A.
Sole Ownership – In the CMS-855I, question one in Section 4A is completed with the Tax Identification Number (TIN). If anything is listed in section 4A question one, a separate NPI number must be obtained for the group number that will be assigned. The individual’s NPI number and information must be listed in section 2A.
Source: CMS internet-only manual (IOM) publication 100-08, chapter 15 external pdf file
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