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Provider Index > Clinical Social Worker > OPRA to Billing

Provider Enrollment & Maintenance




Complete this Enrollment Form if you are:
  1. any ownership related information, and
  2. managing employees, those with a control interest, and agents

IF CHANGES HAVE OCCURRED, DO NOT SUBMIT THIS FORM.
Instead, You Must Complete A New Enrollment Form for Billing Providers.

OPRA to Billing Enrollment Form

If you have any questions or need assistance with your application, please contact the eMedNY Call Center at 1-800-343-9000 or click here to send us an email. Please note, the Medicaid Pending Provider Listing lists all applications that are in process, and the Medicaid Enrolled Provider Listing lists all enrollments that have been approved.


Supplemental Information

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