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How to enroll as a medicaid provider
On screen 1 choose Enrollment
On screen 2 taxonomy must be all CAPITAL LETTERS !
On screen 3 just save and continue to skip
On screen 4 just enter your business name, type of business and tax ID
On screen 5 just save and continue to skip
On screen 6 just enter the name of the main contact person for the business
On screen 7 just enter your business address and info
On screen 8 just enter your business address and info
On screen 9 enter your mailing address and contact info
On screen 10 enter the address where you want your checks mailed
On screen 11 enter the address of your corporate office if you have one
On screen 12 select I do not use a billing agent unless you do
On screen 13 enter the owners information
That’s it !