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If your provider type, supplier type, physician specialty, or non-physician specialty type is not listed in the application, please select other, undefined physician specialty, or undefined non-physician practitioner specialty. Then list your type or specialty in the provided field.
For providers that enroll solely to order or refer services using the CMS-855O, it is a national enrollment. When you relocate to another state, you are not required to disenroll from the current state and re-enroll in the new state, however, a change of information application must be submitted to update the enrollment record (new address, new license, etc.).
Refer to: Requesting SPOT end user role
Yes, for initial, revalidation and reactivation applications, a Puerto Rico and/or U.S. Virgin Islands provider is required to submit a letter of good standing with his or her application if there is no online verification source to verify a medical license. The letter of good standing is not required with a change of information application unless it involves a license update/change.
How do I get a copy of my Medicare approval letter that shows the billing number and effective date?
You can call the JN provider enrollment help desk at 1-888-845-8614 to request a copy of the letter, as long as you're currently listed on the enrollment record. You can also submit a request for a copy of your enrollment certification by sending a request for the information on company letterhead to First Coast’s provider enrollment department. The request needs to be signed by either the authorized official (AO), delegated official (DO) or the practitioner as it is listed on your entity’s enrollment record.
The effective date is the later of the following two dates:
- The filing date of an enrollment application that was subsequently approved, or
- The date the provider first began furnishing services at a new practice location.
The provider may bill retrospectively for services when:
Sole owners who are initially enrolling will use the CMS-855I or the equivalent in PECOS. For practice locations that operate under the same tax identification number (TIN), you will submit only one CMS-855I application; however, you will need to include two Section 4B pages to identify each practice location.
If an enrolled sole owner is adding a new practice location to an existing record, this can be updated on either the CMS-855I or the CMS-855B or in PECOS.
If the practitioner rendering the service is part of a billing group, report the individual practitioner’s NPI in the 'Rendering Physician #' area (2310B loop, segments NM108 [XX] and NM109 [NPI], of the 837P electronic claim or Item 24J of the CMS-1500 paper claim form).