GHI Medicare Enrollment Jurisdiction

GHI Medicare issues Provider Identification Numbers (PINs) to providers / practices that render services in Queens County, New York. If your office is located and/or renders services in an area outside of Queens County, or if the place of service   is outside of Queens County, you must submit your applications and enrollment information to the appropriate Medicare Carrier. The remaining counties in the New York City metropolitan area are serviced by National Government Services (formerly Empire Medicare Services).

Provider Enrollment Updates:

• Suppliers not Eligible for Medicare Part B Enrollment
• General Update Information
• National Provider Identifier
• Prescreening Process
• Electronic Funds Transfer (EFT) Authorization Agreement
• Provider Enrollment Most Common Errors
• Immediate Returns
• Determining Which Forms to Complete
• Requesting Changes to Enrollment
• Medicare Identification Number
• Deactivation Process
• Revalidation Process
• Revocation Process
• Independent Diagnostic Testing Facility
• Application Processing Time
• Participation Agreement CMS - 460 Form

Applications for Enrollment:

• CMS 855I - Medicare Enrollment Application Physicians and Non-Physician Practitioners
• CMS 855B - Medicare Enrollment Application Clinics/Group Practices and Certain Other Suppliers
• CMS 855R - Medicare Enrollment Application Reassignment of Medicare Benefits
• CMS 460 - Medicare Participating Physician or Supplier Agreement
• CMS 588- Medicare Electronic Funds Transfer (EFT) Agreement

Provider Enrollment Mailing Address

Please mail completed applications to:
GHI Medicare
25 Broadway, 13 FL
New York, NY 10004
Attn: Provider Enrollment

Help with Enrollment

Telephone: (877) 868-7965; choose option 7