Welcome prospective providers

Welcome to the First Coast family of Medicare providers. First Coast has been a Medicare administrator for more than 40 years. We are one of the nation’s largest Medicare administrators, and proudly serve more than three million beneficiaries and the health care providers who care for them.

As a prospective provider to the Medicare program, our goal is to help guide you through your enrollment process. To get you started, we have provided several links below to the critical information and education tools you will need to accurately complete the application process. 

Which enrollment form do I choose?

Access the Provider Enrollment Application Assistance Tool for more help in determining the appropriate enrollment form for submission.

How do I complete a CMS-855 form?

The following links will provide you with tools, tips, and step-by-step directions to completing the myriad of CMS-855 forms to help ensure your application processes successfully the first time.

General

• Go here for helpful tips on completing all CMS-855 forms.

CMS-855A (for institutional providers)

• Go here to complete the interactive CMS-855A form. Once completed, print it and submit it.

CMS-855B (for clinics/group practices and certain other suppliers)

• Go here to complete the interactive CMS-855B form. Once completed, print it and submit it.

CMS-855I (for physicians and non-physician practitioners)

• Go here to learn how to complete the CMS-855I form.
• Go here to complete the interactive CMS-855I form. Once completed, print it and submit it.

Electronic Funds Transfer

• Go here to learn how to complete and submit the CMS-588 Electronic Funds Transfer (EFT) form.

Internet-based PECOS

The internet-based PECOS facilitates the Medicare provider enrollment process by furnishing health care providers and suppliers with an easier, faster, and more efficient alternative to paper-based enrollment in the Medicare program. Registered users may use the system for initial enrollment as well as to change, reactivate, or voluntarily terminate an existing enrollment record. Users may also add, change, or terminate reassignment of Medicare benefits.

• Go here to find out how to access the internet-based PECOS.

Where do I submit my provider enrollment documentation?

Medicare Provider Enrollment 

First Coast Service Options Inc. 
P.O. Box 3409
Mechanicsburg, PA 17055-1849

Where can I learn more?

Please review our Part A and B: Provider enrollment FAQs as well as our online education opportunities.