Provider Enrollment

Providers Enrolled in Medicare in Approved or Opt-Out Status Website

Provider Enrollment Resources

  • PECOS - Click here to enroll, change your Medicare information, and add or delete group members or locations. Then 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.
  • Provider Enrollment Revalidation
  • CMS file: providers eligible to order/refer and with current enrollment records
  • Access instructions (PDF, 89 KB) to view your PECOS record using Internet-based PECOS
  • CMS-855 forms access, print, sign and mail to Palmetto GBA:
    Palmetto GBA 
    P.O. Box 100190
    Columbia, SC 29202
  • Dentists to Take Action: CMS-4159-F Medicare Program

Provider Enrollment Tools

Opting Out of Medicare

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Latest Articles

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Provider Enrollment Alert - Issues resulting from recent Provider Enrollment, Chain and Ownership System (PECOS) Release 07/10/2019
Provider Enrollment Open House: Available the First Tuesday of the Month 06/26/2019
Provider Enrollment Application Status Lookup Tool Enhancements 05/24/2019
Opt Out Listing 04/26/2019
Physicians and Non-Physician Practitioners: New Medicare Enrollment Application 02/08/2019
Medicare Provider Enrollment Moratorium 02/01/2019
Provider Enrollment Revalidation Cycle 2 Frequently Asked Questions (FAQs) 10/18/2018
Online Medicare Enrollment: Internet-based PECOS 10/09/2018
Sign Your Medicare Enrollment Application Electronically 10/09/2018
Provider Address Job Aid 08/27/2018
CMS-855O Medicare Enrollment Application Module Open in New Window02/20/2018
Dentists to Take Action: New CMS Initiative 02/19/2018
Private Contract Example - Provider Opt-Out of Medicare 02/18/2018
Changes to the Medicare Opt-Out Law for Physicians and Practitioners 02/14/2018
Medicare Opt-Out Affidavit 02/14/2018
Participation Agreement Form and Instructions 02/14/2018
Provider Address Changes: Important Reminder 02/14/2018
Revalidation Due Date Lookup Tool 02/08/2018
CMS-855 Applications Open in New Window02/07/2018
Credentialing Changes: Submit Updated Information Timely 02/07/2018
Cycle Two Provider Enrollment Revalidation Notifications 02/07/2018
Do You Need to Change Your Address on Your Provider File? 02/07/2018
Do You Need To Reactivate Your Medicare Number? 02/07/2018
National CMS Opt Out Database Open in New Window02/07/2018
Part D Prescribers: Date Change & Phased Enforcement 02/07/2018
Provider Enrollment Email Communications 02/07/2018
Provider Enrollment Revalidation Informational Messaging 02/07/2018
Providers Opting-Out of Medicare: Private Contracting 02/07/2018

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

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