How to Obtain a Medicaid Provider Number

by Andra Picincu - Updated July 25, 2018

Clinics, group practices, physicians and other health care providers can fill out the Medicare enrollment application online. This will allow them to provide services to Medicaid beneficiaries, submit fee-for-service claims and more. Once their application is approved, they receive a Medicaid provider number that serves as a unique identifier.

Tips

  • You can obtain a Medicaid provider number by applying online or in person at a regional office of the Centers for Medicare & Medicaid Services.

What Is a Medicaid Provider Number?

Whether you're a physician or you have your own clinic, you want to provide patients with the best possible rates. That's where Medicare can help. This national health insurance program enables Americans who meet certain criteria to receive discounted medical services. Generally, it covers about half of their health care costs.

In 2015, over 56 million people were enrolled in this program. California alone had more than 5.6 million beneficiaries. Physicians and other medical professionals who wish to participate in this program must apply for a Medicaid provider number. This unique identifier is issued by state health and human services agencies.

The Medicaid provider number also appeals to those who wish to participate in state health care programs, such as Medicaid managed care, the Medicare diabetes prevention program, long-term care services and traditional fee-for-service Medicaid.

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The application process is quick and can be completed online. Look up Medicare provider services enrollment on the official website, contact a representative or visit a regional office of the Centers for Medicare & Medicaid Services.

Submit Your Application Online

If you wish to apply online, access the CMS.gov website. Check the Medicare enrollment resources for providers and then head over to the PECOS section. Before filling out your application, it's necessary to register for a national provider identifier. All health care providers based in the U.S. are required to have this unique identification number.

If you already have a national provider identifier, you can apply for a Medicaid provider number right away. Simply create a user account and fill out the enrollment form. You will need to provide an email address, enter a password and confirm your identity. Your application will be approved or declined within 45 days. Paper-based enrollment, on the other hand, takes about 60 days.

Other Ways to Obtain a Medicaid Provider Number

The Centers for Medicare & Medicaid Services has 10 regional offices in different cities and states. Atlanta, Chicago and New York are just a few to mention. If you want to enroll in the Medicare provider services program in person, go to the nearest regional office.

Any questions related to the enrollment process and other services can be communicated by phone. For example, if you have general questions about the program, you may call 800-633-4227, the Medicaid phone number. Another option is to access CMS.gov, select Contacts Database and search for a Medicaid office for a Medicaid customer service representative in your area.

Health care professionals can also fill out and mail their enrollment forms and all supporting documentation to a local Medicare administrative contractor servicing their state. Signatures must be handwritten. The application forms are available on the CMS.gov website under the Enrollment Applications section.

About the Author

Andra Picincu is a digital marketing consultant with over nine years of experience. She works closely with small businesses and large organizations alike to help them grow and increase brand awareness.

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