Medicare Provider Number Application Tips

The Medicare Program is a health insurance program of the U.S. Government.  U.S. citizens and permanent residents are eligible for Medicare coverage if they (or their spouses) worked 10 years or more in employment covered by Medicare and are at least 65 years old.

Additionally, persons less than 65 years old can be covered by Medicare benefits if they are disabled or have end-stage renal disease requiring either kidney dialysis or a transplant.

Before Medicare patients can be accepted by a health care provider, however, it is necessary for the provider to submit a Medicare application.

Below are some tips for a health care provider to get faster approval of its Medicare application.

Medicare coverage and information is subject to change without notice. Always check with your local Medicare professional for the most recent information.

1.  Obtain A National Provider Identifier (NPI) Before Applying

Health providers must supply a valid NPI on the Medicare application.

2.  Health Providers and Suppliers Should Submit The Most Recent Version

The Centers for Medicare & Medicaid Services (CMS) revised the CMS-
855 Medicare enrollment applications starting May 1, 2006.  Health care providers must complete that version of the form at the time of this writing.  The Medicare application version is located in the lower left-hand corner of the form.

3.  Health Providers and Suppliers Should Submit The Proper Form Type

The Medicare application form differs for each type of health care provider.  For example, a doctor’s office, ambulance provider, and mental health care institution would each submit a different version of the form.  Each provider’s form lists the types of providers that can utilize it.

4.  Include All Supporting Documentation

All requested records must accompany the completed Medicare application.  These records may include professional and business licenses, identification numbers, and other professional documents.

5.  Make Sure Your Application Is Complete

Submitting an incomplete Medicare application requires the agency to either contact you for the missing information, or return the form for completion.  Save time by supplying all information the first time.

6.  Health Providers and Suppliers Should Submit To The Proper Place

Different contractors process the Medicare application from different parts of the country.  Submitting the completed form to the wrong address will delay the enrollment.

7.  Include All Application Fees If Required

Certain institutions must include a Medicare application fee.  The provider must include all information to pay this fee via electronic transfer.

8.  The Responsible Official Must Sign And Date The Form

The Medicare application process for providers can sometimes be difficult, so failure to sign and date the form is a common mistake.

9.  Handle Medicare Application Information Requests Promptly

The contractor handling a provider’s form may have questions.  Prompt responses can keep the application process going.

Most health care providers can get their Medicare application approved faster if they follow a careful and methodical approach to completing the enrollment form.

101 Responses to Medicare Provider Number Application Tips

  • Gloria Johnson says:

    Hi I am a Mental Health Therapist and I would like to know if I can have my own provider number for my company? I have been clicking for a while now and haven’t clicked on the application yet. LOL help! My question is very simular to Radha above. thanks in advance for your help

  • kathy says:

    seeking to be private lpn contractor/self employed, how does one begin, this process

  • Anita says:

    How do I apply for my own medicare provider number? I have curently a medicare provider number through my employer.

  • Marlene Catanese says:

    I am a contracted ED physician with TeamHealth (TN) and another smaller ER group….they bill on my behalf……..I am now leaving to work for a community heath center..do I have my own medicare/ medicaid numbers or would those numbers be assigned to the groups I work for?
    My NPI # 1548202815 and UPIN E54177 Thanks

  • I am changing employers.
    New employer requests my Medicare & Medicaid numbers.
    I already have my NPI number.
    Not sure why my current employer only has my UPIN & NPI #’s.
    They state ‘that these are the only numbers they need to bill for
    my servises (?)’
    But the new employer states I need all the other #’s as well.
    Can you help me retrieve my Medicare & Medicaid numbers?

    My NPI # is 141704897
    UPIN: H 55619

    Thank you!
    Maria

  • Faheem Ahmed says:

    I have medicare provider numer. But I am planning to move to a different state and want to start my own practice. Do I need to obtain new provider numner, if yes, how long would it take the numnber.
    Thanks,
    Faheem Ahmed.

  • Gloria Parker says:

    How do I get started as a Medicare transporter in Georgia? What website do I need to visit to get the provider number?

  • DeeDee says:

    How do I locate my provider number?

  • Boni says:

    have NP that has a MC number do I need to get a number for the office in order to bill MC or can bill under the NP’s number

  • Chandra williams says:

    i need to find out how do you get a npi , medicare and medicaid provider number for my elderly care service.

  • adrienne burrows says:

    I am 6 years out of residency. I have worked for 2 large mulitispecialty groups since completing residency. I have a medicaid provider number, but I am unsure whether or not this number is my own number or if it is attached to one of the large groups that I previously worked for. How do I find out the answer to this question?

  • Nora Reznickova says:

    How do I apply for my own medicare provider number? I have curently a medicare provider number through my employer.
    Thank you for your assistance to this matter.

  • Nora Reznickova says:

    Same as no. 10
    How do I apply for my own medicare provider number? I have curently a medicare provider number through my employer.
    Thank you for your assistance to this matter

  • William Jasper says:

    I am a Licensed Clinical Social Worker and I would like to apply to become a medicaid health care provider. What are the steps, what is the process?

  • Chris says:

    I used to accept medicaid in my dental practice 10 years ago in Michigan, how can i find out if i am still and active provider and retrieve my medicaid provider number?

  • Angela Gaskins says:

    I have an NPI number, what else do I need to to open a non-profit facility in my rural community for children after school. I’m an LPN and I want to be able to give the children in this community a place to go after school to get a healthy snack, activities and education of prevention of childhood obesity. help with homework, donate clothes, school supplies, mentoring and counseling.

  • meg says:

    I am wondering how I apply for a Medicare Provider number to start my own Home Care business?

  • Ometa Pope says:

    I am starting a non-emergency transporation business for children and families and would like to apply for a Medicaid Provider number. I am located in New Jersey. Can you offer assistance in how to begin the process?

    Thank you in advance.

  • TOM COLLORD says:

    I have a medicare provider number through a company that Iwork, I sent the CMS form to change the provider address to my address, but they have not sent it, what can I do tp get my medicare provider number from them.

  • i need the number to medicad can u plz give that to me

  • Wanda Miles says:

    How do i apply for a medicare provider number i want to start my own buiness?

  • John Davis says:

    I am a board certified physician assistant and I already have a NPI number. I need to know if i need different numbers for medicare and medicaid to be a provider? If so, I need details on how to do this electronically.

  • james johnson says:

    i am interested in applying for a new provider number for a non medical foot health by a nurse practitioner. is this possible, and how do i go about obtaining a provider number for medicare?

  • Connie Barber says:

    I was wanting information on after becoming a provider. How long is the provider number good for if you don’t have a client at this time (Ohio)

  • Fred says:

    I am employed by a hospital in WV and have my medicare number and NPI etc linked through my employer who bills for my services.

    Now my employer allows me to do some contract work, so how do I go about billing under my separate employer id linked to my LLC?

  • Kim McRae says:

    Currently I am taking care of my mother who has Alzheimer’s. Can I get a health care provider number? We live together in her home in Birmingham, Alabama. Thank you Kim McRae

  • mmh says:

    Is there a service that helps with the provider application process? I’ve had problems with the forms and the process.

  • Evan Sade says:

    If anyone has any questions regarding the Medicare enrollment process feel free to email your questions to Evan Sade @www.medicareconsulting.com.

  • sonja says:

    I WANT TO KNOW HOW I CAN SET UP DIRECTING PAYMENT FROM MEDICARE AND MEDICARE? STARTING OWNING PHYSICAL THERAPIST AS ACONTRACTOR .

  • Samuel says:

    I AM INTERESTED IN RECIEVING A MEDICARE PROVIDER NUMBER AND I AM AWARE THAT IN ORDER TO PLACE AN APPLICATION FOR MEDICARE PROVIDER, I NEED TO HAVE A NPI NUMBER . CAN YOU DIRECT ME ON THE STEPS THAT NEED TO BE TAKEN TO AQUIRE THE TWO. I reside in Texas

  • Rosha says:

    I have newly certified by ACHC agency how long will I wait before I get the provider number

  • Michelle Bazel says:

    My dad resides in Ohio and I am trying to get him to move to MI…He currently has his Medicare established in Ohio. How do I set up Medicare in MI ( we are anticipating a stay longer than 6 mos). Any ideas as to where I should begin?

  • AKinyele says:

    I’m starting a non-emergency transportation service and wanted to no do I need a medicare provider number and if so how do I obtain one. I am located in Georgia.

  • Bebee E says:

    HELP !!
    If a provider already hasa individual Mediare number can she use her individual number for her provider group which consist of two other individuals? For instance…Jackie Doe individual number is 456987 but she wants to use the same Medicare number for Jackie Doe Family Practice.

  • Susan Thompson, LCSW says:

    I would like to know how to obtain an NPI number as well as a Medicare provider number. I may have had a Medicare provider number in the past.
    I am looking into doing some mental health work.
    thank you.
    Susan Thompson

  • Thomas says:

    I am in the process of starting an IDTF. I have the NPI & Tax ID Number. I have been told by several people I can test Medicare recipients during the wait for my provider number, then once I receive my provider number, I can bill for those tests conducted prior to the MPN. Is this true? If so, where can I find the statement?

  • Velencia says:

    I want to start my own HomeHealth agency . I would like to know what do i have to do to obtain the permit otr the license? Also i need to know the requirements to do so.

  • Donna says:

    I am interested in starting a DME company in Florida and Texas. How do I apply for a Medicaid number? Please respond with a phone number that I can call with additional questions.

    Thank you in advance & GOD Bless you for your Service!!

  • Danru Lee says:

    How do I apply for my own medicare provider number? I have curently a medicare provider number through my employer.
    Thank you for your assistance to this matter.

  • Marshall says:

    How do you look up a Medicare provider number that isn’t listed on the CMS website?

  • Jinhee Choi says:

    I am a physical therapist and I have a medicare provider number through my empolyer. I am opening my own clinic in other location but planning to keep working for my current employer. How do I get my own medicare provider number?

  • wanda says:

    Hi I have been trying to located the proper forms to send to medicate, I’m opening my business and I have three patient on standby but have been told that I need to submit some forms. Can anyone assist me with this matter ASAP. Thank you

  • Jeff Ross says:

    how long does it take a DME to get PTAN from medicare, we’ve been in the process for 10 months

  • Linda Drumsta says:

    I am a LPN currently providing private duty/private pay homecare. I am interested in obtaining a provider number for Medicaid/Medicare. Could you please lead me in the correct procedure to apply for this.
    Thank you.

  • Sybil Cummin says:

    I am an LPC with a private practice and would like to be able to accept medicaid for my services. How do I go about doing this?

    Thanks!

  • THEOLAR BUTLER says:

    I NEED SOMEONE TO GIVE ME INFORMATION ON GETTING A MEDICAID AND MEDICARE PROVIDER NUMBER.I NEED TO KNOW WHO CAN I GO TO TO HELP ME IN FILLING OUT THE NECESSARY PAPER WORK TO GET STARTED.ALSO PLEASE TELL ME WHAT MEDICAID AND MEDICARE OFFER A PROVIDER FOR THEIR SERVICES?

  • Shanea Foy says:

    Hi, I am a LPN ion Maryland. How can i getan independent providr number for MD, DC, Va, Pa and deleware areas. I am intrested in becoming an independent provider for medicaid.

  • dave says:

    Am considering repairing power chairs as a business, how do I get a provider number to submit claims and do I need one?

  • shi-yu tan says:

    how do I find out my medicare and medicaid provider numbers if I misplaced my paperwork?
    Thanks

  • teresa says:

    my husband recently had his medicare number reactivated. My question is, since federal is governed over state why can’t he get his medicaid number reactivated? Thank You.

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