Part A Resources: Provider Enrollment
- Enroll or change your facility's Medicare information online at https://pecos.cms.hhs.gov. Print, sign and date the two-page Certification Statement. Then mail the Certification Statement and all supporting paper documentation to CGS within seven days of electronic submission.
- CMS Fact Sheet (PDF, 693 KB): enrollment information for all institutional providers
- Access the CMS-855A form (PDF, 784 KB). Then print, sign and mail it to CGS.
- Mail paper applications to:
CGS
J15 Part A Provider Enrollment
P.O. Box 20004
Nashville, TN 37202 - Call the Provider Contact Center at (866) 590-6703 for additional assistance
Articles and Resources
- Further Details on the Revalidation of Provider Enrollment Information – 03.16.12
- Health Care Provider Taxonomy Codes (HPTC) Update: April 1, 2012 – 03.01.12
- Revalidation Request Form – 01/20/2012
- Provider-Based Attestation Statement – 09/28/2011
- CMS 855A Medicare Enrollment Application – 09/23/2011
- Further Details on the Revalidation of Provider Enrollment Information – 09/23/2011
- Internet-Based Medicare Enrollment Now Available to Provider and Supplier Organizations in All States and in the District of Columbia – 09/23/2011
- Provider-Based: General Information – 09/23/2011
- Provider-Based: Off-Campus Outpatient Coinsurance Notice – 09/23/2011
- Provider-Based: Terms and Definitions – 09/23/2011
- Health Care Provider Taxonomy Codes (HPTC) Update: October 1, 2011 – 08/16/2011
- Further Details on the Revalidation of Provider Enrollment Information – 08/08/2011
- Effective Date of Certified Provider or Supplier Agreement or Approval – 04/04/2011
- Implementation of Provider Enrollment Provisions in CMS-6028-FC – 03/25/2011
- How Institutional Providers Will Pay the Medicare Enrollment Application Fee beginning Friday, March 25 – 03/24/2011
