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  1. provider.enrollment.dpw.state.pa.usPROMISe™ Internet Portal > Home

    To enroll, providers can complete an on-line provider enrollment application and supply any required supporting documentation. This includes providers who are not billing PA Medicaid or CHIP but provide services to beneficiaries. All applications will be screened based on Federal and State guidelines prior to an enrollment decision.

    • Login

      To enroll, providers can complete an on-line provider...

    • Application Status

      Upon submission of the correct information, you will receive...

  2. www.pa.gov › en › agenciesProvider Enrollment Information | Department of Human Services...

    Use the Online Provider Enrollment portal to submit a new application, for revalidation, or for reactivation. Benefits of using the secure online portal: Allowing documents to be uploaded directly to the portal. Permitting providers see the status of their submission. Decreasing wait time to review applications.

  3. www.pa.gov › en › servicesEnroll as a Medicaid Provider | Commonwealth of Pennsylvania -...

    How do I enroll in the Pennsylvania Medicaid program and what are the requirements for enrollment? Detailed enrollment information, including the application and requirements, as well as the Electronic Provider Enrollment User Manual, can be found on the PROMISe Provider Portal .

  4. provider.enrollment.dpw.state.pa.us › Home › StartNewRequest Information - Provider Enrollment Application

    You are initiating a provider enrollment application for the Pennsylvania Department of Human Services (DHS) Medical Assistance (MA) program and/or the Pennsylvania Children's Health Insurance Program (CHIP).

  5. promise.dhs.pa.gov › DefaultPROMISe™ Internet Portal > Home

    PROMISe™ Internet Portal > Home

  6. promise.dhs.pa.gov › portal › providerRegistration Selector - promise.dhs.pa.gov

    Registration. Select one of the following options that best describes your role. An individual or entity that is enrolled in the Pennsylvania Medicaid program as a provider of services. An account created by a Provider for use by an individual within the provider's organization.

  7. provider.enrollment.dhs.pa.gov › ApplicationStatusApplication Status - Provider Enrollment Application

    Application Status. Enter your application tracking number (ATN), Federal Tax Identification Number (FEIN or SSN) and password in order to review your application status. If you have any questions about completing an electronic enrollment application, please call the appropriate phone number shown on the Important Phone Numbers and Addresses ...

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