Transcription of MEDICARE ENROLLMENT APPLICATION
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MEDICARE ENROLLMENT APPLICATION
MEDICARE ENROLLMENT APPLICATION . durable medical equipment , Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers CMS-855S. SEE PAGE 1 FOR A LIST OF THE DMEPOS SUPPLIER STANDARDS. TO ENROLL IN THE MEDICARE . PROGRAM AND BE ELIGIBLE TO SUBMIT CLAIMS AND RECEIVE PAYMENTS, EVERY DMEPOS SUPPLIER. APPLICANT MUST MEET AND MAINTAIN THESE ENROLLMENT STANDARDS. SEE PAGE 2 TO DETERMINE IF YOU ARE COMPLETING THE CORRECT APPLICATION . SEE PAGE 4 FOR INFORMATION ON WHERE TO MAIL THIS APPLICATION . SEE SECTION 12 FOR A LIST OF SUPPORTING DOCUMENTATION TO BE SUBMITTED WITH THIS. APPLICATION . TO VIEW YOUR CURRENT MEDICARE ENROLLMENT RECORD GO TO: Form Approved DEPARTMENT OF HEALTH AND HUMAN SERVICES OMB No.
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers. ... The NPI is the standard unique health identifier for health care providers and suppliers and is assigned by . the National Plan and Provider Enumeration System (NPPES). To enroll in Medicare, you must obtain an NPI ...
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