Answer a few questions about your practice structure to identify the correct enrollment path, required CMS-855 form, NPI type, and supporting documents — avoiding costly application delays.
ProgressQuestion 1 of 3
Question 1
How do you bill Medicare for your clinical services?
This determines whether we look at individual provider or entity-based enrollment.
Question 2
Do you operate as a sole proprietor — meaning you ARE the business?
A sole proprietor uses their SSN or an EIN tied directly to themselves (not a separate legal entity like an LLC or corporation). You may have a DBA name but no formal business structure.
Question 2
What type of business entity do you have?
This determines whether your entity is treated as a pass-through (disregarded) or as a separate taxpaying organization — which directly affects your NPI type and CMS-855 form.
Question 3
Does your single-member LLC have its own EIN, and do you bill Medicare under that EIN?
Because a SMLLC is a disregarded entity, the IRS lets you use either your SSN or the LLC's EIN as the billing TIN. Your answer changes which documents CMS requires — but not your NPI type or form.
Question 3
How many rendering providers bill through this group entity?
Count all licensed providers (physicians, NPs, PAs, therapists) who would be enrolled under the group's Medicare billing number.
Question 3
Do you have a separate EIN for your sole proprietorship (not your SSN)?
Some sole proprietors obtain an EIN from the IRS for banking, payroll, or identity-protection purposes. This affects what documents CMS requires, but does not change your enrollment path or form.
Disclaimer: This tool is for educational guidance only and does not constitute legal or regulatory advice. CMS enrollment requirements may change. Always verify current requirements at PECOS and the CMS Provider Enrollment page or consult a qualified credentialing specialist before submitting your application.
