Get CMS-855O 2013
CATION AND FOR INFORMATION ON WHERE TO MAIL THIS COMPLETED APPLICATION. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Form Approved OMB No. 0938-1135 WHO SHOULD COMPLETE AND SUBMIT THIS APPLICATION Most physicians and non-physician practitioners enroll in the Medicare program to be reimbursed for the covered services they furnish to Medicare beneficiaries. However, with the implementation of Section 6405 of the Affordable Care Act, CMS requires certain phys.
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