CMS-855A · Form guide

Form 855A for institutional providers

Hospitals, hospices, FQHCs, home health, skilled nursing. You sign it. Enrollment Watch does not.

Part A is about 12% of future-dated organizational rows in the October 2026 file. Most of the future file is Part B and DME.

What the form is actually about

• Provider type
• Practice locations
• Authorized officials
• Chain home office, if any

Returns we see when a package comes back

• Authorized official cannot be reached
• A subunit was left on the enrollment

Check the public NPI record before you type

The free lookup shows the NPI, the state, and which form to file. The paid check compares the address and specialty with the public NPI registry. It cannot see your PECOS screen.

Example NPI lookup · Form 855A