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Welcome to the Provider Enrollment home page. Here you will find a complete array of documents necessary to successfully complete your enrollment process. There are now two approaches to locating your enrollment forms:
For maintenance forms go to the Provider Maintenance Forms page. (A good example of a Maintenance form is the new Default Electronic Transmitter Identification Number (ETIN) Selection form. This form will be essential in order to see Medicare Crossover Claims reported on your electronic remittance).
For specific enrollment needs, click on your provider type below and learn all about enrollment for your type.
We have also provided a Provider Enrollment Guide. If you have any questions or concerns, please contact the eMedNY Call Center at 1-800-343-9000 or email us at webmaster @ emedny.org.
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