Last Modified: 2/23/2021
Location: FL, PR, USVI
Business: Part A, Part B
Q: How do I complete a CMS-855 form? How can I be sure that I have everything I need?
Medicare enrollment applications/forms (CMS-855A, CMS-855B, CMS-855I
, and CMS-855R
) must be completed with accurate information and include all supporting documentation. First Coast offers several online resources
to assist you during the provider enrollment process including:
• Clinics/group practices and certain other suppliers: CMS-855B • Physicians and non-physician practitioners: CMS-855I
• Provider enrollment tips, terms, and specialty codes:
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.