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.
Montana's
Healthcare Programs NPI Reenrollment Application
(for participation after October 1, 2007)
07/2008
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
