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Click ‘Get Form’ to open it in the editor.
Begin by entering the date at the top of the form. This is essential for processing your request.
Fill in your email address to ensure you receive any correspondence regarding your application.
Provide the Legal Business Name and Tax Identification Number (TIN) accurately, as these are critical for identification.
Complete the Payment/Remit Address section, including City, State, and Zip Code. This information is necessary for billing purposes.
Next, enter the Practice Location Address along with its City, State, and Zip Code.
Input individual NPI and Local MAC PTAN details. If applicable, include Group NPI # and Local MAC Group PTAN as well.
Finally, provide your phone number and submitter name before submitting the form electronically through our platform.

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How do I look up a PTAN number?

You can lookup a National Provider ID (NPI) on the National Plan Provider Enumeration (NPPES) website by clicking Search NPI Registry.

How to look up railroad Medicare claims?

Telephone Inquiries - If you would like to check the status of your Railroad Medicare Part B claim, you may call the Palmetto Interactive Voice Response (IVR) system toll-free at (800) 833-4455. From the main menu, press one 1 for claim status.

How do I look up my PTAN number?

Locating Your PTAN Number Reference the notification letter sent by your MAC when your enrollment in Medicare was approved. Log in to the PECOS online portal. Click on the My Enrollments button, then View Enrollments. Locate the applicable enrollment and click on the View Medicare ID Report link.

Is railroad Medicare ptan the same as Medicare ptan?

The first step in becoming a Railroad Medicare provider is to request and receive a Railroad Medicare Provider Transaction Access Number (PTAN). You will need a separate PTAN for Railroad Medicare because we are a different jurisdiction from your local Part B Medicare Administrative Contractor (MAC).

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