NPI Provider Reenrollment
Thank you for choosing to reenroll as a Montana Medicaid, CHIP Dental or Extended Mental Health and/or MHSP provider. The documents below contain all the information you need to reenroll. If you have any questions, please contact Provider Relations by calling 1-800-624-3958 or 406-442-1837 or sending an e-mail to mtprhelpdesk@acs-inc.com.
On-line reenrollment is now available through the Montana Access to Health Web Portal. As of March 2, 2007, only providers without Internet access will be allowed to complete a paper application.
Montana's Healthcare
Programs NPI Reenrollment Application
(for participation after October 1, 2007)
05/2007
Please review the Enrollment Checklist on pages 2 and 3 and complete, sign
and return all applicable pages.
Application Supplemental
Information
05/2007
This document contains taxonomy codes and license and certification requirements
to help you complete your application. These pages are for reference
only and do not need to be returned.
Frequently
Asked Questions
05/2007
This document contains questions frequently asked about the NPI reenrollment
process and forms.
Online Reenrollment Tutorial
03/2007
