Enrollment - Providers - Upstate Medicare Division

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Provider Enrollment

In order to submit claims for services rendered to a Medicare beneficiary, a provider must have a Provider Transaction Access Number (PTAN). These numbers are issued by the Provider Enrollment Unit.

A Provider Enrollment Form must be completed and submitted with the appropriate documents to the Provider Enrollment Unit. Once this is received and processed, the provider will be notified in writing of their PTAN.

Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications (GEN)
Delay of Enrollment Requirement for Audiologists (GEN)
Document Available to Assist with Completing Provider Enrollment Forms (GEN)
National Plan and Provider Enumeration System (NPPES) Data Dissemination Notice (CMS-6060-N) (GEN)
New Electronic Funds Transfer (EFT) Authorization Agreement (CMS-588) (GEN)
Enrollment Aids (GEN)
Contractor Returning the CMS-855 Application (GEN) - Revised 11-1-07
Developing for Information on a CMS-855 Application (GEN)
Electronic Funds Transfer - Mandatory (GEN)
Requests for Release of Provider Transaction Access Number (PTAN) (GEN)
NPI and the New Medicare Provider Enrollment Process (GEN)
Medicare Enrollment for Physicians, Non-Physician Practitioners and Other Health Care Suppliers (104KB) (GEN)
Facilitating Your Medicare Enrollment (GEN)
Announcing the Release of the Revised CMS 855 Medicare Enrollment Applications (GEN)
CMS Announces the National Provider Identifier (NPI) Enumerator Contractor and Information on Obtaining NPIs (GEN) - Revised 5-11-07
Important Notice Regarding Clinical Social Workers Enrolled in Medicare Prior to September 1, 2004 - Revised 5-23-06
Electronic Funds Transfers (EFTs) (GEN) - Revised 5-23-06
CMS 855 Application Guidelines (GEN) - Revised 7-20-07
Provider File Changes (GEN)
CMS Provider Enrollment Web Site for Enrollment Forms (GEN) - Revised 5-23-06
Common Errors on the CMS-855 Application (GEN) - Revised 11-1-07
Authorized Official and Delegated Official Signature (GEN) - Revised 9-21-06
Practitioners with Limited License (GEN) - Revised 3-10-08
IDTF Supervising Physician (IDTF) (PHY)
Provider Enrollment Contacts (GEN)

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This page updated
April 9, 2008