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Provider Enrollment > Optometrist (OPT)

Provider Enrollment




Option 1

Self Employed... Billing Medicaid

If you Do/Will Provide Medical Services and Bill Medicaid Click here for the Enrollment Form and Instructions.


Please Note: If you only will Order/Prescribe/Refer/Attend see Option 3 Below
Option 2

Salaried... Billing Medicaid

If you Do/Will Provide Medical Services and Bill Medicaid Click here for the Enrollment Form and Instructions.


Please Note: If you only will Order/Prescribe/Refer/Attend see Option 3 Below
Option 3

Order/Prescribe/Refer/Attend ONLY

If employed by a Physician or Group Practice and you will NOT be Billing Medicaid, click here for the Enrollment Form and Instructions.


If you Do/Will Provide Medical Services and Bill Medicaid, see Option 1 above
Option 4

Change From OPRA To Billing Provider

If you are already enrolled as an Order/Prescribe/Refer/Attend (OPRA) Provider and wish to provide Medicaid Services and Bill Medicaid, Click here for the Enrollment Form and Instructions.

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