Provider Enrollment

If you are a provider interested in serving Medicare patients, CMS requires you to be enrolled with Medicare. The links below will provide you with the tools and information needed to quickly and efficiently complete your Medicare enrollment.

Provider Enrollment Resources

  • Enroll, change your Medicare information, and add or delete group members or locations using the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) at Then electronically sign the application or upload the two-page Certification Statement via PECOS functionality. Contractors can no longer accept mailed paper certification statements. Mail all other supporting paper documentation to Palmetto GBA within seven days of electronic submission.
  • Access the CMS-855A form (PDF, 771 KB). Then print, sign and mail it to Palmetto GBA.
  • Access the status of your CMS-855 application
  • CMS file: Providers eligible to order/refer and with current enrollment records
  • Enrollment Application Status Lookup
  • Medicare Revalidation Lookup Tool
  • Palmetto GBA address for mailing enrollment forms:

Palmetto GBA
Part A Provider Enrollment (AG-331)
2300 Springdale Drive, BLDG One
Camden, SC 29020 

Provider Enrollment Articles