Provider List Filter

Select a radio button to filter the list of providers below



Provider Enrollment & Maintenance

new enrollment

Are you interested in Enrolling in the NYS Medicaid Program?

Are you a Practitioner who needs to enroll as an Ordering, Prescribing, Referring or Attending (OPRA) non-billing Provider?

Are you a Business, Group, or Institutional (Facility) provider that is part of a Medicaid Managed Care (MMC) Network that is required to enroll with NYS Medicaid per the 21st Century Cures Act?

Do you want to enroll a different NPI for another Enrollment Type?

existing enrollment

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?

If any of these questions apply to you,
click on your provider type on the right



Useful Information


As of March 25, 2011, new Federal Rules and Regulations surrounding provider screening and enrollment have been in effect. Please refer to the Federal Register 42 CFR Parts 405, 424, 447 et al. for the complete set of rules and regulations. Changes include: additional screening may be required, all ordering and referring physicians or other professionals providing services under the State plan or under a waiver of the plan must be enrolled as participating providers, revalidation of enrollment of all providers at least every five (5) years, and an application fee may apply.

All Medicaid Provider Enrollment forms include information on the Provider Compliance Program requirements found in Title 18NYCRR, Part 521.

Click here for the list of Providers requiring application fee payments.






ATTENTION: New Enrollment Section!
The enrollment section has been enhanced with the following features:
  • Easier Navigation
  • Forms are more Accessible
  • Requirements and Instructions are more Clearly Defined
  • Improved Interaction and Performance
new enrollment pages

Click Here for a help document