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Provider Enrollment


To enroll a Community Residence sponsored by the Office of Mental Retardation and Developmental Disabilities (OMRDD) in New York State Medicaid, you must have a Provider Agreement through OMRDD. Prospective providers should contact OMRDD at (518) 402-4333 for requirement details and licensing.

Enrollment Checklist
 

To expedite the enrollment process, you can begin collecting copies of documents that you will need to include when you submit the completed enrollment form:

A copy of your FEIN documentation showing both the name and number preprinted (a W-9 is not sufficient for enrollment purposes).

 

A list of the facility's or program's owners and/or Board of Directors with addresses.
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