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Insert provider contact information here Notice of Medicare Coverage Patient name:Patient number:The Effective Date Coverage of Your Current insert typeServices Will End: insert effective date Your
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Medicare provider andor is the organization or individual that provides medical services to Medicare beneficiaries.
Healthcare providers who have provided services to Medicare beneficiaries are required to file a medicare provider andor.
You can fill out your medicare provider andor online through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS).
The purpose of medicare provider andor is to ensure accurate billing and reporting of services provided to Medicare beneficiaries.
Information such as provider name, address, National Provider Identifier (NPI), services provided, and Medicare enrollment status must be reported on the medicare provider andor.
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