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  • Application For An Initial Medicare Providerregistration - Humanservices Gov

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Application for an initial Medicare provider/registration number for an Allied Health Professional Purpose of this form An application from a physiotherapist, osteopath, chiropractor or podiatrist.

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Related content

Enrollment Applications | CMS
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Contact support

Apply online (at Social Security) – This is the easiest and fastest way to sign up and get any financial help you may need. You'll need to create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online. Call 1-800-772-1213. TTY users can call 1-800-325-0778.

CENTERS FOR MEDICARE & MEDICAID SERVICES. INSTRUCTIONS FOR THE MEDICARE PARTICIPATING PHYSICIAN. AND SUPPLIER AGREEMENT (CMS-460) To sign a participation agreement is to agree to accept assignment for all covered services that you provide to Medicare patients.

The Centers for Medicare & Medicaid Services (CMS) is a Federal agency within the U.S. Department of Health and Human Services. Many CMS program related forms are available in Portable Document Format (pdf).

Is CMS the same as Medicare? No. The Centers for Medicare & Medicaid Services (CMS) is part of the U.S. Department of Health and Human Services (HHS) and is not the same as Medicare. Medicare is a federally run government health insurance program, which is administered by CMS.

What is the 855A? ❖ The Medicare Enrollment Application for Institutional Providers. ❖ This form is also used to submit changes to your enrollment data.

Form # CMS 855I. Form Title. Medicare Enrollment Application - Physicians and Non-Physician Practitioners.

Participating supplier means a supplier that has an agreement with CMS to participate in Part B of Medicare in effect on the date of the service. Payment on an assignment-related basis means payment for Part B services -

Medicare Provider Agreement means an agreement entered into between a state agency or other entity administering Medicare in such state and a health care facility or physician under which the health care facility or physician agrees to provide services or merchandise for Medicare patients.

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© Copyright 1997-2025
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3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232