Last Modified: 5/23/2018
Location: FL, PR, USVI
Business: Part A, Part B
Provider enrollment application types
Q: How do I know which provider enrollment application to use?
A: You may either use the Provider Enrollment, Chain, and Ownership System (PECOS) 
to enroll online or mail a paper application form. PECOS supports the Medicare provider and supplier enrollment process by capturing provider/supplier information from the CMS-855 family of forms. The system manages, tracks, and validates enrollment data collected in both paper form and electronically via the internet. To find out more about PECOS, please refer to the PECOS FAQs .
to enroll online or mail a paper application form. PECOS supports the Medicare provider and supplier enrollment process by capturing provider/supplier information from the CMS-855 family of forms. The system manages, tracks, and validates enrollment data collected in both paper form and electronically via the internet. To find out more about PECOS, please refer to the PECOS FAQs . The direct link for each Medicare provider/supplier enrollment application is shown below:
Note: CGS Medicare is the DMEPOS Medicare Administrative Contractor (MAC) for Florida, Puerto Rico, and the U.S. Virgin Islands.
is the DMEPOS Medicare Administrative Contractor (MAC) for Florida, Puerto Rico, and the U.S. Virgin Islands.Note: The Centers for Medicare & Medicaid Services approved two new enrollment forms, CMS-855C and CMS-855POH. For more information, access the change request (CR) 9120 
and the CMS Forms List page.
and the CMS Forms List page.Not sure which CMS-855 form to complete? Learn more here.
Access the Provider Enrollment Application Assistance Tool for more help in determining the appropriate enrollment form for submission.
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