Logo
ISO 9001:2000
Menu Arrow
Menu Top
Menu Arrow
Menu Top
Menu Arrow
ISO Certified

Medicare Information Resource

Note: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material which is copyrighted by the American Medical Association (AMA). You are forbidden to download the files unless you read, agree to and abide by the provisions of the copyright statement. Read the copyright statement now (you will be linked back to here).

Medicare Information Resource Part A and B Combined
MIR-2006-6AB, June 2006

Revised CMS-855 Medicare Provider Enrollment Applications

On May 1, 2006, the Centers for Medicare & Medicaid Services (CMS) introduced the revised CMS-855 Medicare provider enrollment applications. As part of the revised enrollment process, initial enrollees and existing enrollees making changes to their enrollment information must include their National Provider Identifier (NPI) number and a copy of the National Plan and Provider Enumeration System (NPPES) NPI notification with the enrollment application. No initial application can be approved and no updates to existing enrollment information can be made without this NPI information. All health care providers and suppliers who bill Medicare are required to obtain their NPI in advance of enrolling in or changing their Medicare enrollment data.

If you are an individual or sole proprietor who furnishes health care, you are eligible for one, and only one, NPI. If you are an individual who is a health care provider and who is incorporated, you may need to obtain an NPI for yourself and an NPI for your corporation or LLC. If you are an organization that furnishes health care, you may determine that you have components, called “subparts,” that need their own NPI. For additional information about the NPI, please go to http://www.cms.hhs.gov/NationalProvIdentStand/ External link.

If you have not yet obtained your NPI number, CMS encourages you to do so soon, even if you are not enrolling or making a change to your Medicare enrollment information. An information sheet designed to provide basic information about the NPI, including the three different ways to apply for your NPI, is available at http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/EnrollmentSheet_WWWWH.pdf External pdf file. Whatever method you use to obtain your NPI, be sure to keep this information, share it with your health care partners, and update your information with NPPES whenever any of the information used to get your NPI changes .

Starting May 23, 2007, the NPI will replace all of your existing provider numbers that you use to bill Medicare, Medicaid, and other health care payers. Although this date is still a year away, you should begin sharing this information with Medicare, other payers, and your other health care partners in order to make the transition to NPI as smooth as possible.

For more information about the revised provider enrollment process, please contact your Medicare contractor or go to http://www.cms.hhs.gov/MedicareProviderSupEnroll External link.

CMS Learn Resource 200605-16

 

   
 
Spacer Image
 Translate this page >> 
 
 
 
 
 
 
 
 
 
 
Copyright