Provider Enrollment > Optician/Opthalmic Dispenser (OPD)

Provider Enrollment

Option 1

Billing Medicaid (Self Employed or Salaried)

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 2 Below

Option 2

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 3

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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