Loading
Get Application For A Medicare Provider Number For An Allied Health Professional
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Application For A Medicare Provider Number For An Allied Health Professional online
Applying for a Medicare provider number as an allied health professional can be a straightforward process if you follow the right steps. This guide will assist you in filling out the online application accurately, ensuring that you have all necessary information on hand to avoid delays in approval.
Follow the steps to complete your application online.
- Click ‘Get Form’ button to obtain the form and open it in the provided environment.
- Begin by indicating whether this application is for an initial or subsequent Medicare provider number. Select 'Initial' or 'Subsequent' as appropriate.
- Provide your personal details, including your family name, first name, second name, date of birth, and gender.
- List any languages you speak other than English, if applicable.
- Select the health profession category for which you are applying for a provider number, and ensure to tick only one box.
- Indicate whether you are applying for more than one location. If yes, you will need to complete additional sections for each location.
- Fill in the location start and end dates, if necessary.
- Enter your practice information such as the name of your practice, address, and contact number.
- Provide your postal address and business contact details.
- Include your professional qualifications, AHPRA registration number, and attach copies of any relevant registration certificates as required.
- Complete your business details, including your Australian Business Number (ABN) and Australian Company Number (ACN) if applicable.
- Select the type of your business and specify the premises type where you will be providing services.
- Answer yes or no to whether your practice uses Medicare Online and Medicare Easyclaim.
- Fill out your bank account details accurately, ensuring that there are no restrictions on the account for Electronic Funds Transfer.
- Carefully review all your entries for completeness, sign the form, and date it.
- Submit the completed form along with any required documentation to the Department of Human Services either by mail or fax.
Begin your application online today to secure your Medicare provider number.
Is NPI the same as Medicare Provider Number? A National Provider Identifier (NPI) is a unique 10-digit identification number for insured healthcare providers. In 2007, NPI took over MPN. At the same time, MPN was also renamed to CMS Certification Number (CCN).
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.