Provider Enrollment

Optician/Opthalmic Dispenser (OPD) — Individual Billing Medicaid

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

Optician/Opthalmic Dispenser (OPD) — Non Billing - Ordering/Prescribing/Referring/Attending (OPRA) or Managed Care Network Provider

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

Optician/Opthalmic Dispenser (OPD) — Change From Non Billing (OPRA or Managed Care Network Provider) To Billing Provider

If you are already enrolled as a non-billing OPRA or managed care network provider and wish to bill fee-for-service Medicaid, click here for the Enrollment Form and instructions.