Medicare

How to Get Credentialed with Palmetto GBA (Jurisdiction J/M) in North Carolina

Network: Open
60-90 Days

Quick Overview

Timeline

60 - 90 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

North Carolina-Specific Requirements

Palmetto GBA (MAC Jurisdiction J/M) processes all Medicare Part A/B claims for North Carolina. Providers enroll through PECOS using CMS-855I (individual) or CMS-855B (group). North Carolina has a large and growing provider network, with significant Medicare populations in both urban centers (Charlotte, Raleigh-Durham) and rural eastern counties. CMS standard screening applies for most provider types. A valid NPI is required, and revalidation is every 5 years. Initial enrollment processing typically takes 60–90 days; revalidation takes 30–60 days.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for North Carolina.

2

Prepare Your Application

Complete Palmetto GBA (Jurisdiction J/M)'s provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Palmetto GBA (Jurisdiction J/M).

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

CV/Resume

DEA License

Conditional

Required if applicable

Malpractice Insurance

Medical License

NPI Certificate

Contact Information

Claims Inquiry

National

1-855-696-0705

Medicare Enrollment

National

Medicare Appeals

National

1-855-696-0705

Quick Links

Palmetto GBA (Jurisdiction J/M) Website Provider Portal

Need Help?

Let PayerReady handle your Palmetto GBA (Jurisdiction J/M) enrollment in North Carolina.

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Palmetto GBA (Jurisdiction J/M) in Other States

Alabama Georgia South Carolina Tennessee Virginia

Other Payers in North Carolina

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Blue Cross and Blue Shield of North Carolina NC Medicaid UnitedHealthcare Community Plan
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