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Welcome to the Online Provider Enrollment Process

The Provider enrollment application is not used to revalidate. Enrolled providers are instructed to visit the Revalidation FAQ page on the public website if they need to revalidate.

Please complete each step in the enrollment process. Required fields are noted. You will be able to save the information and return using the tracking number assigned by the system. When you have completed all steps of the application, print a copy of the information for your records, “submit” and “confirm” the application for processing.

Please click the “Continue” button to start the enrollment process.

Want to make sure your application is processed as quickly as possible?

Please do NOT begin your application before reviewing all of the training resources available. Starting an application prior to reviewing the training materials will likely result in an incomplete or incorrect application. An incorrect or incomplete application requires additional review, which may add weeks of additional processing time. Please visit the Provider Enrollment web page. Be sure to review the Find Your Provider Type web page before you begin the online trainings – it will help you select the correct training, right from the start.

 R05.00.362