License and Certificate Renewals

Whether you are an individual, a group or a facility, it is a best practice to submit licenses and certifications upon their renewal to keep your enrollment up to date. This helps avoid potential claim denials, deactivations, or revocations.

License and certification updates may be submitted at any time as no application is required. Licenses and certifications may be mailed or faxed, include a cover letter that includes legal business name and NPI/PTAN to indicate the enrollment it applies to.

FAX number:

  • Part B 701-277-7868

If you are unable to fax, please provide the information outlined below and return to our office by mail. Mail the completed license or certification(s) to: 

USPS:
Medicare Part B
Attn: Provider Enrollment
PO Box XXXX
Fargo, ND 58108-XXXX

FedEx/Ups:
Medicare Part B
Attn: Provider Enrollment
900 42nd St S
Fargo, ND 58103

Replace XXXX above with the PO Box and Zip Code Extension

State PO Box/Zip Ext
N CA (CA) 6774
S CA (CB) 6775
HI 6777
NV 6776

 

            Last Updated Mon, 15 Feb 2021 17:36:57 +0000