It is very important that providers update their provider file once a change of address is made. The incorrect information on the provider file could lead to your correspondence from Palmetto GBA being delivered to an incorrect address, office or building.

Address changes and provider file updates must be submitted through Internet-based Provider Enrollment, Chain and Ownership System (PECOS) or on the proper Centers for Medicare & Medicaid Services (CMS) form, depending on the type of provider/supplier. A CMS-855I is required for an individual, a CMS-855B is required for an organization, and a CMS-855A is required for institutional providers.

Change of Address:
Using Internet-based PECOS
Find information about the Centers for Medicare & Medicaid Services’ change of address information on the Internet based Provider Enrollment Chain and Ownership System (PECOS). 

If you are familiar with Internet-based PECOS, use the following link to log in:

Note: Internet-based PECOS is the preferred method for submitting initial applications or making address changes to your provider file.

Change an Address on a Paper Enrollment Application
The direct link for each Medicare provider/supplier enrollment application is shown below:

  • CMS 855A for Institutional Providers (PDF, 771 KB)
  • CMS 855B for Clinics/Group practices and Certain Other Suppliers (PDF, 661 KB)
  • CMS 855I for Physicians and Non-Physician Practitioners (PDF, 522 KB) 

Contact Palmetto GBA JJ Part A Medicare

Provider Contact Center: 877-567-7271

Email JJ Part A

Contact a specific JJ Part A department

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