If you are experiencing problems submitting claims due to issues with your NPI number, please be aware that Palmetto GBA will request additional information from you to resolve some of these situations. The most common reason for our requests for more information is the existence of multiple locations (and multiple PTANs) when we do not have sufficient information to match your NPI with your physical location. These requests may cause delays in processing your claims.
In order to avoid or minimize these delays, please take the following steps:
- Ensure that your NPPES data are correct and that the NPPES record(s) contains the Medicare legacy identifier(s) that was assigned to the provider to whom the NPPES record belongs. For example, a physician/practitioner applying for an NPI would list his/her Medicare PTAN in the 'Other Provider Identifiers' section of the NPI application, but would not list the PTAN of the group in which he/she is a member. Palmetto GBA uses this information in building the Medicare NPI crosswalk, which is used to process your claims. To view or edit your NPPES record, go to https://nppes.cms.hhs.gov/ on the CMS Web site. For assistance, call the NPI Enumerator at (800) 465-3203.
- If your NPI and NPPES information are correct and you continue to receive 'informational' NPI messages, rejects or returns, verify that your Medicare enrollment information on file with Palmetto GBA is accurate
- As instructed in the CMS 855I application, all changes of information, including additions and deletions, must be submitted within 90 days of the effective date of the change. All place of service locations for your practice or group must be on file with Palmetto GBA.
- Consider consolidating multiple PTANs into a single number to ensure a one-to-one NPI to PTAN match. You may collapse PTANs that are assigned to additional locations only if the additional locations are all assigned the same tax identification number (TIN) and are within the same pricing locality. More information about consolidating multiple PTANs is available in the CMS MLN Matters article MM5906 (PDF, 74 KB).
Questions? We Are Here to Help!
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Your Location
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Type of Question
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Contact Number
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Jurisdiction 1
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Your current provider enrollment information, completing CMS-855 applications, or to collapse your PTANs
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Provider Contact Center:
(866) 931-3901
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Problems with claim denials or rejections
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Provider Contact Center:
(866) 931-3901
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Ohio or West Virginia
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Your current provider enrollment information, completing CMS-855 applications, or to collapse your PTANs
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Provider Enrollment Support Line:
(866) 308-5439
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Problems with claim denials or rejections, or customer service related questions
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Provider Contact Center:
(866) 332-7025
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South Carolina
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Your current provider enrollment information, completing CMS-855 applications, or to collapse your PTANs
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Provider Contact Center:
(888) 828-2092
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Problems with claim denials or rejections, or customer service related questions
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Provider Contact Center:
(888) 828-2092
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