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Medicaid Provider Enrollment

Provider Enrollment Information:

Medicaid Provider Enrollment Electronic Application Information (MMIS)

Required Documents for Online Enrollment

All completed applications should be mailed to:

North Dakota Dept. of Human Services
Medicaid Provider Enrollment
600 E. Boulevard Ave., Dept. 325
Bismarck, ND 58505-0250

If you have any questions on enrollment call:

North Dakota Medicaid Provider Enrollment
1-800-755-2604 or 701-328-4033
Monday through Friday
8 a.m. to 4:30 p.m. (CT)

 

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