Medicare Enrollment Application Submission Options All eligible provider and supplier organizations can apply for enrollment in the Medicare program, make a change in their enrollment information, or voluntarily withdraw from Medicare
by using either:

• Internet-based Provider Enrollment, Chain and Ownership System (PECOS)


• The paper enrollment forms (i.e., the CMS-855A or the CMS-855B forms).


• Suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)    do not, at this time, have the option of using Internet-based PECOS. The availability of   Internet-based PECOS to DMEPOS suppliers will be announced at a future date.

• Some enrollment scenarios cannot be accommodated by Internet-based PECOS at this    time. These scenarios are listed in the document entitled, “Overview of Internet-based  Provider Enrollment, Chain and Ownership System (PECOS) – Information for Provider and Supplier Organizations,” available from the Downloads Section of this web page.

What Are Provider and Supplier Organizations?

Provider and supplier organizations are entities that meet the Medicare definitions of “provider” and “supplier” and have business structures of corporations, partnerships, professional associations, or limited liability companies. Provider and supplier organizations do not include business structures that are sole proprietorships or “disregarded entities” as defined by the Internal Revenue Service (IRS).

The Employer Identification Number (EIN) issued by the IRS is the Taxpayer Identification Number (TIN) of an organization provider or supplier. Examples of providers and suppliers that are usually organizations as defined in this document include hospitals, medical group practices and clinics, portable X-ray suppliers, ambulatory surgical centers, hospices, skilled nursing facilities, and others. Provider and supplier organizations must enroll in Medicare and keep their enrollment information up to date in order to be eligible to receive Medicare payments for covered services furnished to Medicare beneficiaries.