Resume/Revalidate Enrollment

Welcome to the Online Provider Enrollment System

Resume Enrollment

Enter the Tracking number and Password used during your initial enrollment application and select Resume to continue.

Revalidation

The Tracking Number and Password required to start your revalidation request is sent to providers 90 days prior to the revalidation due date, you must have the Tracking Number and Password to start the revalidation, if you have not received the tracking number and password and your revalidation is due within 90 days, call 1-800-933-6593 to request your information.

Enter the Tracking number and Password and select Resume to continue.

Processing...