CMS-855B · Form guide

Form 855B for clinics, groups, and certain suppliers

Organizational suppliers that are not DMEPOS and not institutional. You sign it. Enrollment Watch does not.

The MAC letter goes to the correspondence address on the last approved 855, which is often a person who left.

What the form is actually about

• Practice locations
• Managing employees
• Adverse legal actions
• Billing agency, if any

Returns we see when a package comes back

• A location closed and nobody removed it
• The managing employee left

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 855B