Do you need to make a change to your current enrollment record?
Do you want to correct an existing NPI for your current Enrollment?
Did you receive a letter advising you to Revalidate your enrollment?
Have you experienced an Ownership Change?
Do you want to Reactivate/Reinstate your status in NYS Medicaid?
Are you a Practitioner who would like to modify your current Enrollment from OPRA (non-Billing) to Billing Provider?
Are you a Practitioner who would like to modify your current Enrollment from Billing Medicaid to Pay to Group Only?
Are you a Business, Group, or Institutional Facility that needs to modify your current Enrollment from a Billing Provider to MMC Provider?