Answer:
To change your address, complete one of the following CMS forms within 30 days of the date of the change (on paper or online) based on your "provider type:"

  • CMS-855B: to change the address of a provider group
  • CMS-855I: to change the address of a sole practitioner or other independent entity or to change the address of individuals that belong to a group

Options:

  • Download the appropriate CMS 855 form from the Enrollment Application Finder tool. Complete, print, sign and mail the form to Palmetto GBA.
  • Complete and submit your application through the PECOS website. Your application may be processed up to 50 percent faster than applications submitted on paper. 
    • Important: Print, sign and date the two-page Certification Statement and mail the Certification Statement and all supporting paper documentation to Palmetto GBA within seven days of electronic submission

Tips:

  • You may also need to change your address with the NPI enumerator at https://nppes.cms.hhs.gov
  • Don’t forget to change your address with other insurance carriers, including Medicaid

Resource:

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department



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