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2. CMS 855B | CMS - Centers for Medicare & Medicaid Services

   www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS...

   Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers

3. MEDICARE ENROLLMENT APPLICATION - Centers for Medicare ...

   www.cms.gov/.../CMS-Forms/Downloads/cms855b.pdf

   Clinics, group practices, and other suppliers can apply for enrollment in the Medicare program or make a change in their enrollment information using either: • The Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or • The paper CMS-855B enrollment application. Be sure you are using the most current version.

4. Welcome to the Medicare Provider Enrollment, Chain, and ...

   pecos.cms.hhs.gov/pecos/login.do

   PECOS supports the Medicare Provider and Supplier enrollment process by allowing registered users to securely and electronically submit and manage Medicare enrollment information. New to PECOS? View our videos at the bottom of this page.

5. Medicare Enrollment Application - HHS.gov

   www.hhs.gov/guidance/sites/default/files/hhs...

   Clinics and group practices can apply for enrollment in the Medicare program or make a change in their enrollment information using either: •The Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or •The paper enrollment application process (e.g., CMS 855B).

6. Enrollment Forms (CMS-855) - Novitas Solutions

   www.novitas-solutions.com/webcenter/portal/...

   Clinics and group practices can apply for enrollment in the Medicare program or make a change to their existing enrollment information using the CMS-855B. Complete this application if you are an organization/group that plans to bill Medicare and you are:

7. Completing the Medicare Enrollment Application - Clinics ...

   www.novitas-solutions.com/webcenter/portal/...

   Clinics and group practices can apply for enrollment in the Medicare program or make a change to their existing information using the Clinics/Group Practices and Other Suppliers (CMS-855 B) application.

8. Enrollment Application Finder - Palmetto GBA

   www.palmettogba.com/palmetto/webTool.nsf/vtool/pea

   This tool provides links to CMS-855 applications. Use the links available in the lower portion of this page to find which application(s) are appropriate for your provider/group type or the type of provider enrollment action you would like to take.