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Provider Enrollment

Welcome to the WPS Medicare Provider Enrollment web page.

Internet-based PECOS (Submit your application online)

Access to Internet-based PECOSExternal Link
CMS Internet-based PECOS InformationExternal Link
Internet-based Medicare Provider Enrollment

Completing Your Application

Interactive Tool

CMS Internet-based PECOS Education

PECOS Enrollment Example Webinar - Sole ProprietorZIP File
PECOS Enrollment Example Webinar - Sole OwnerZIP File
PECOS Enrollment Example Webinar - Change of InformationZIP File
PECOS Enrollment Example Webinar - Reassignment of BenefitsZIP File
PECOS Enrollment Example Webinar - Two DirectorsZIP File


Revalidation of Medicare Enrollment

Check the status of your enrollment application

Enrollment Application Status Inquiry (EASI)

Provider Enrollment Telephone Number

(866) 518-3285
7:00 am to 5:00 pm Central Time
Monday - Friday
Fax Number: (608) 301-2740

Provider Enrollment Addresses

Wisconsin Physicians Service
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery Mailing Address
Wisconsin Physicians Service
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834

What is Provider Enrollment?

Provider enrollment is a critical function for ensuring that only qualified individuals and entities meeting CMS eligibility criteria are enrolled in the Medicare program and receive reimbursement for services furnished to Medicare beneficiaries.

Physicians, non-physician practitioners, suppliers, and other qualified providers must first enroll in the program in order to submit claims and receive payment for Medicare covered services.

WPS Medicare is responsible for Medicare Part B provider enrollment for Iowa, Kansas, Missouri, and Nebraska.

WPS Provider Enrollment Information

Appealing Medicare Provider Enrollment Determinations
E-Mail Development Requests on Provider Enrollment CMS-855 Applications
Effective Billing Date Determination
Effective Date of Reactivation
Medicare Denial for Secondary Insurers
Medicare Enrollment of Ordering/Referring Providers
Physicians in Residency and Fellowship Programs
Provider Enrollment Changes
Provider Specialty Codes
Providers Responsibility for Knowing
Release of Medicare Provider Enrollment Information
Reporting Changes of Information
Return and Development of CMS-855 Enrollment Applications

Participation Information

NOTE: CMS is extending the 2014 Annual Participation Enrollment Program. The participation enrollment period will now end January 31, 2014, instead of December 31, 2013.

Medicare Participating Physician or Supplier Agreement
Medicare Participation for Calendar Year 2014
Medicare Participation Program

WPS Medicare Resources

Independent Diagnostic Testing Facilities (IDTF)
New Providers
Opting Out of Medicare

CMS Links

CMS FormsExternal Link
Medicare Provider-Supplier EnrollmentExternal Link

Frequently Asked Questions (FAQs)

To view the Provider Enrollment FAQs, select Departmental from the FAQ top navigation drop down menu; then choose "Provider Enrollment", you will then be directed to the FAQ page.


If you are searching for a specific Provider Enrollment form, please utilize the "Forms" option within the top navigation bar.

Page Last Updated: Monday, 28-Jul-2014 12:41:29 CDT