Get Tax Update Form - Emedny

The Tax Update Form - EMedNY is essential for updating taxpayer information on your New York State Medicaid file. This guide will provide you with step-by-step instructions to ensure your form is completed accurately and efficiently online.

Follow the steps to complete the Tax Update Form - EMedNY online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your Taxpayer Information, including your 8-digit Medicaid ID and 10-digit National Provider Identifier (NPI). Ensure that these numbers are accurate as they appear in your Medicaid records.
3. To update your Taxpayer Address, input the new address in the provided fields. Make sure to include the street address, city, state, and zip code without using abbreviations.
4. If you are adding a Federal Employer Identification Number (FEIN) as an individual, enter your individual NPI and the new FEIN in the designated spaces. Attach the required IRS letter but leave the Social Security Number (SSN) box blank.
5. For those who are self-incorporated or belong to a group entity, complete the form with your organizational NPI. Remember that if you have not enrolled as a group with NYS Medicaid, you cannot add a FEIN using this form. Provide the new FEIN and attach the required IRS letter while leaving the SSN box blank.
6. If you need to change your Taxpayer ID from a FEIN to an SSN, fill out the form by leaving the FEIN section blank and entering your SSN in the appropriate box.
7. To correct any inaccuracies in your Taxpayer ID, enter the correct FEIN or SSN as necessary. For FEIN corrections, remember to attach the IRS letter confirming your Employer Identification Number.
8. After entering all necessary information and attaching any required documents, review the form for completeness and accuracy.
9. Finally, save your changes, and you can choose to download, print, or share the completed form as required.

Ensure your taxpayer information is up-to-date by completing the Tax Update Form - EMedNY online today.