This guide walks through the PECOS enrollment submission process step by step — from starting your application through the signature and submission. Before you start, confirm you have a PECOS account and your I&A credentials. Account setup guide →

This guide covers individual provider enrollment (equivalent to CMS-855I). Organization enrollment (CMS-855B) follows similar sections but includes ownership disclosure and chain of ownership sections.

Before you start: checklist

Have these ready before opening PECOS:

Active NPI (Type 1 for individuals) — confirmed active in NPPES
Correct taxonomy code in NPPES — must match your specialty
Current state license number(s) and expiration date(s)
Social Security Number
Current malpractice insurance certificate (provider name, policy number, dates, coverage amount)
Physical practice address (no P.O. Box)
Bank account information for EFT (you’ll file CMS-588 separately, but have it ready)
Any adverse legal history information ready to disclose

Step 1: Log in and navigate to enrollment

Go to pecos.cms.hhs.gov. Log in with I&A credentials.

On the PECOS home screen, you’ll see your linked provider/organization records. For a new enrollment, click “Start New Enrollment” or “Enroll” next to your NPI.

Step 2: Select enrollment type

PECOS will ask you to confirm:

Individual or organization enrollment
Your provider type / specialty category

Select your primary specialty. For most providers, the taxonomy in NPPES should match what you select here. PECOS will flag mismatches.

Step 3: Identifying information

PECOS pulls from your NPPES record automatically. Verify:

Legal name (must match exactly)
NPI
Date of birth
Social Security Number (entered, not pulled from NPPES)

Correct any discrepancies in NPPES before proceeding if you find mismatches.

Step 4: Practice location(s)

Primary practice location: Enter your main practice address. Requirements:

Physical address (street, city, state, ZIP)
No P.O. Boxes
Phone number and fax number for the location
Taxonomy/specialty for this location

Additional locations: If you practice at multiple locations, add each one. Each location should have:

Its own address
Applicable taxonomy
Indication of whether it’s the primary location

⚠️ Practice location accuracy matters for claims. If you see patients at a location not listed in your enrollment, claims from that location may be reviewed or denied. Add all active practice locations.

Step 5: Correspondence address

This is where CMS and your MAC will mail:

Development letters requesting more information
Revalidation notices
PTAN assignment letter
Any adverse action notices

This is often the most important address in your enrollment. If you use a billing company or practice management service, consider whether their address or yours is more reliable for receiving official CMS correspondence.

⚠️ Don’t use a P.O. Box for correspondence if you can avoid it. P.O. Boxes are acceptable for correspondence (unlike practice addresses), but physical addresses are more reliable for certified mail.

Step 6: Licensure and certification

Enter each active state professional license:

State
License type (medical license, PT license, LCSW license, etc.)
License number
Effective date
Expiration date

PECOS will validate that your license is not expired. Enter licenses for all states where you’re currently practicing or intend to practice.

Board certifications (if applicable): Some specialty enrollments ask for board certification information (especially for surgical specialties). Enter if prompted.

Additional certifications: DEA registration (if applicable), hospital privileges, specialty certifications per your provider type.

Step 7: Adverse legal history

This section asks about:

Criminal convictions (excluding minor traffic violations)
Prior Medicare/Medicaid exclusions
License revocations or suspensions
Prior Medicare or Medicaid program sanctions
Felony convictions in the past 10 years

Answer honestly. If you have something to disclose, disclose it. CMS checks the OIG exclusion list and state licensing databases. Omissions are worse than disclosures.

If you have something to disclose, you can add an explanation. Many historical actions don’t automatically disqualify enrollment — omitting them does.

Step 8: Upload supporting documents

Documents to attach in PECOS:

Required for most individual providers:

Copy of current state license (PDF, <5MB)
Malpractice insurance certificate (current year)
If applicable: DEA registration, board certification

Required for specific situations:

Foreign medical graduates: ECFMG certificate
New graduates: Residency/training completion documentation
Name change: Legal documentation

Use PECOS’s document upload feature. Accepted formats are typically PDF. Label your documents clearly.

Step 9: Review and sign

Before submitting, PECOS presents a summary of your entire application for review. Go through each section:

Verify all addresses are correct
Verify all license information is accurate
Verify the correspondence address is the one you want to use
Verify your taxonomy/specialty selection

Electronic signature: Click through to the certification page. Read the certification statement (you’re certifying the information is accurate and you understand Medicare fraud and abuse requirements). Enter your I&A password to sign electronically.

Step 10: Submit

Click “Submit.” You’ll receive:

A PECOS application ID number (save this)
A confirmation screen (take a screenshot or note the confirmation number)
A confirmation email to your I&A email address

Your application is now in your MAC’s review queue.

After submission: what to do

Day 1 after submission:

Save your application ID and confirmation
File your CMS-588 (EFT Authorization) by paper to your MAC — you can do this immediately without waiting for approval

Days 30, 60, 90:

Log in to PECOS and check your application status
If status shows “Pending Completion,” you have a development letter waiting — check your correspondence address for a letter and respond within 30 days

At approval:

You’ll receive a letter at your correspondence address with your PTAN and effective date
Configure your billing system with your PTAN
Begin billing for dates of service on or after your effective date

⚠️ Risk flags

⚠️ Don’t bill before your effective date. Your Medicare billing privileges begin on the effective date CMS assigns — not when you submitted or when you were approved. Claims for services before the effective date are denied.

⚠️ Address the development letter within 30 days. If your MAC sends a development request and you don’t respond within 30 days, your application is denied. You’d have to start over with a new application.

⚠️ Duplicate submissions cause delays. Don’t submit a second PECOS application if you haven’t heard back — it doesn’t speed things up. Contact your MAC’s provider enrollment department if you have concerns about a stalled application.

Questions about a specific PECOS section or enrollment step? Ask Mae →