What shall I do if I don't have an enrollment record in Medicare?

Answer:
You need to submit either an electronic application through the use of internet-based PECOS, or a paper enrollment application to Medicare.

  • For paper applications: fill it out, sign and date it, and mail it along with any required supporting paper documentation to your designated Medicare enrollment contractor
  • For electronic applications: complete the online submittal process and either e-sign or mail a printed, signed and dated Certification Statement and digitally submit any required supporting paper documentation to your designated Medicare enrollment contractor
  • In either case, the designated enrollment contractor cannot begin working on your application until it has received the signed and dated Certification Statement
  • If you will be using Internet-based PECOS, please go to Internet-based PECOS and on the left-hand side, read the information that has been posted there. Download and read the documents in the Downloads Section on that page that relate to physicians and nonphysician practitioners. A link to Internet-based PECOS is included on that web page.
  • If you order or refer items or services for Medicare beneficiaries and you do not have a Medicare enrollment record, you need to submit an enrollment application to Medicare. You can do this using Internet-based PECOS or by completing the paper enrollment application (CMS-855O)

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

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Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

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