The Pennsylvania Department of Human Services (DHS) offers an online Electronic Provider Enrollment Application. The electronic application allows providers to apply for enrollment with the Medical Assistance (MA) program.
The three types of online applications are new application (brand new provider never enrolled with PA Medicaid), revalidation (provider currently enrolled with PA Medicaid), and reactivation (provider re-enrolling with PA Medicaid). Access the online application.
Questions? Contact the DHS Program Office at 1-800-537-8862 with any questions or concerns. Members of the Pennsylvania Medical Society (PAMED) also can contact PAMED’s Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.
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