Contact Us
|
Login
Logout Confirmation
Are you sure you want to logout?
Logout Confirmation
If you navigate away from this page, you will lose unsaved data. Are you sure you want to logout?
Home
Home
>
Provider Enrollment
>
Enrollment Status
Wednesday 05/01/2024 10:10 AM MST
Provider Enrollment - Status
Back to Home
Enter your assigned tracking number and Tax ID to verify the current status of your enrollment application. For any further queries, please refer to the Provider Resources web page for additional information such as FAQs, Fact Sheets, and other communication regarding Provider Enrollment.
*
Indicates a required field.
*
Tracking Number
Tracking Number is a required field.
The text field contains invalid characters. Acceptable characters include [a-z], [A-Z], [0-9], spaces and characters [.?!,()-_+';:"].
*
Tax ID Number
Tax ID Number is a required field.
Tax ID Number is not valid or in the correct format. Enter a valid value in the format '999999999'.
R05.00.362
Privacy Notice