Enrolling for the First Time or Moving From Another State?

Individuals enrolling for the first time or moving from another state must complete the following:

• To bill Medicare as an individual NPP, you must complete the CMS-855I as indicated in the instructions;
  
  
• An individual must complete a CMS-855I for each state where they perform their services;
  
  
• A CMS-855R must be completed to authorize reassignment and submitted with the CMS-855I; and
  
  
• A sole proprietor must also include a completed CMS-855B.

Individuals enrolling for the first time must also complete a CMS-460, the Medicare Participating Physician or Supplier Agreement.

Individuals who have completed a CMS-855I from a previous employer only need to complete the CMS-855R for reassignment.