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Last Modified: 12/13/2017 Location: FL, PR, USVI Business: Part A, Part B

Sole owner but multiple locations FAQ

Q: I am the sole owner of two practice locations. Do I need to submit a CMS-855I for each location?
A: For practices that operate under the same Tax Identification Number (TIN), you will need to submit only one CMS-855I application; however, you will need to include two Section 4C pages to identify each practice location.
For practices that operate under separate TINs, you will need to submit separate CMS-855I applications for each of the practices.
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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.