Provider Index > Dentist > 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



Supplemental Information

If you have any questions or concerns, please contact the eMedNY Call Center at 1-800-343-9000 or click here to send us an email.