855i 2026

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The document is a checklist for the revalidation process of CMS-855I and CMS-855R applications for Physicians and Non-Physician Practitioners (NPPs). It outlines required sections, reminders, and necessary attachments for various types of practitioners, including sole owners and physician assistants. The checklist ensures that all relevant information is completed accurately to facilitate the revalidation of Medicare identification numbers.

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Click ‘Get Form’ to open the CMS-855I in the editor.
Begin with Section 1A, where you must enter all individual Medicare identification numbers (PTANs) alongside your NPI. Ensure to check the revalidation box.
Proceed to Section 2, completing all subsections (2A, 2B, and 2C) as they apply to your application process.
In Section 3.1, if you answer 'Yes', make sure to complete Section 3.2; simply stating 'See Attached' is not acceptable.
Fill out Section 4B with all association information for each PTAN identified in Section 1A.
Finally, ensure that you provide an email address and fax number in Section 13 and sign in Section 15 before submitting your form.

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