If you would like to enroll or make a change to your existing Medicare enrollment record, you can do either of the following:
- Use Internet-based PECOS prior to 9/29 or after 10/3. For more information about Internet-based PECOS, see the appropriate “Getting Started” guide available in the Downloads section. There is a “Getting Started” guide for physicians and non-physician practitioners and one for provider and supplier organizations.
- Complete and submit the paper Medicare provider enrollment applications(s) (CMS-855) along with any required supporting documentation and mail the application(s) to the appropriate Medicare carrier, fiscal intermediary, or A/B MAC. The CMS-855 forms are downloadable from the CMS forms page.