CMS 855B Enrollment Form

Effective July 1, 2021 an updated version of the CMS-855B enrollment form will be available for clinics, group practices, and other suppliers who have a Type 2 NPI. Medicare will accept version (7/23) of the CMS-855B application form until June 30, 2021. If form is submitted after this date the application form will be returned. The most current form can be found on the Noridian Enrollment Forms Webpage to access all updated CMS 855B application forms.


            Last Updated Wed, 16 Jun 2021 15:15:27 +0000