(*) Red asterisk indicates a required field.
PECOS supports the Medicare Provider and Supplier enrollment process by allowing registered users
to securely and electronically submit and manage Medicare enrollment information.
New to PECOS? View our videos at the bottom of this page.
According to the Paperwork Reduction Act of 1995, no persons are required to respond
to a collection of information unless it displays a valid OMB control number.
The valid OMB control numbers for this information collection are 0938-1056, 0938-1135 and 0938-0685.
Depending on the applicant's provider/supplier type and reason for submission of this information, the
time required to complete this information is estimated to be between 15 minutes and 6 hours per response,
including the time to review instructions, search existing data resources, gather the data needed and
complete and review the information collection. If you have any comments concerning the accuracy of the
time estimates or suggestions for improving this form, please write to: CMS, Attn.: PRA Reports Clearance
Officer, 7500 Security Boulevard, Baltimore, MD 21244-1850.
WARNING: Only authorized registered users have rights to access PECOS.
Unauthorized access to this system is forbidden and will be prosecuted by law.
By accessing this system, users are subject to monitoring by system personnel.
Anyone using this system expressly consents to monitoring and is advised that
if such monitoring reveals possible evidence of criminal activity, system personnel
may provide the evidence of such monitoring to law enforcement officials.