CorporateBusiness Services

Provider Enrollment

  • Enroll or change your facility's Medicare information online at https://pecos.cms.hhs.govExternal Website. Print, sign and date the two-page Certification Statement. Then mail the Certification Statement and all supporting paper documentation to CGS within seven days of electronic submission.
  • CMS Fact SheetExternal PDF (693 KB): enrollment information for all institutional providers
  • Access the CMS-855A formExternal PDF (784 KB). Then print, sign and mail it to CGS.
  • Mail paper applications to:

    CGS
    J15 Part A Provider Enrollment
    P.O. Box 20004
    Nashville, TN 37202
  • Call the Provider Contact Center at (866) 590-6703 for additional assistance

Updated: 10.14.16


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