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 OMB No 0938 0931 NATIONAL PROVIDER IDENTIFIER NPI 2005

2005-2025 Form

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[Music] on page three of the online application you will enter your provider's npi and dea if applicable if you are a non-emergent medical transportation provider your npi is not required and you will not have a dea to add your provider's npi click add npi and enter the mpi number click save to add the gea click add dea and enter the dea number click save answer the question are you or have you been previously enrolled as a medicaid provider in another state if your provider has been enrolled in another state's medicaid agency click yes if not click no if yes enter the medicaid state they were enrolled in scroll to the bottom and click the save copa information is not required make sure that the page has been saved successfully and then click continue at the bottom to move on to the next page

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