Provider Enrollment Options
Reference a list of providers that are eligible to enroll through:
- PAVE
- PAVE (eligible specialized enrollment options)
- A paper form
- The California Department of Public Health
- Other divisions or departments
Provider Types Eligible to Enroll Through PAVE
- Acupuncturist
- Air Ambulance Transportation
- Ambulatory Surgical Clinic (Physician-Owned only)
- Audiologist
- Blood Bank
- Certified Mastectomy Fitter
- Certified Nurse Midwife
- Certified Nurse Practitioner
- Certified Registered Nurse Anesthetist
- Chiropractor
- Clinical Laboratory
- Community-Based Organization
- County Exempt from Licensure Clinic Not Associated with Hospital
- Dentist – generalist or specialist
- Diabetes Prevention Program
- Dispensing Optician
- Doula
- Drug Medi-Cal Clinic
- Drug Medi-Cal Clinic Medical Director
- Drug Medi-Cal Licensed Substance Use Disorder Treatment Professional
- Durable Medical Equipment
- Exempt from Licensure Clinic
- Hearing Aid Dispenser
- Licensed Clinical Social Worker
- Licensed Marriage and Family Therapist
- Licensed Midwife
- Licensed Professional Clinical Counselor
- Local Health Jurisdiction
- Medical and Non-Medical Ground Transportation
- Naturopathic Doctor (ORP Only)
- Nurse Practitioner (Supervised)
- Occupational Therapist
- Ocularist
- Optometrist
- Orthotist
- Outpatient Heroin Detox Center
- Out of State Hospital
- Pharmacy
- Pharmacist (ORP Only)
- Physician Assistant (Supervised and ORP)
- Physician/Surgeon
- Physical Therapist
- Podiatrist
- Portable Imaging
- Prosthetist
- Psychologist
- Qualified Autism Service Provider
- Registered Dental Hygienists
- Registered Dental Hygienists in Alternative Practice
- Registered Dental Hygienists in Extended Functions
- Respiratory Care Practitioner
- Speech Pathologist
- Tribal Health Services
- University Dental Provider
PAVE-Eligible Specialized Enrollment Options (For Applicable Provider Types)
- Clinic-Based Provider
- Facility-Based Provider
- Hospital-Based Provider
- Medicare Crossover-Only Provider
- Ordering, Referring, Prescribing (ORP) Provider
- Out of State Provider
- Rendering Provider
Provider Enrollment Requests Completed via Paper Forms
- Change of National Provider Identifier (Varies by Provider Type. To find out more, call (916) 323-1945 or submit an Inquiry Form)
- PIN Verification Request (DHCS 6209)
- Change of Ownership or Location for Exempt from Licensure Clinics that have become FQHC/RHC
Provider Types Eligible to Enroll Through California Department of Public Health
Visit the California Department of Public Health to enroll:
- Alternative Birth Centers – Specialty Clinic
- Birthing Center Services
- Certified Hospice
- Chronic Dialysis Clinic
- Community Clinic
- Community Hospital (Inpatient & Outpatient)
- County Hospital (Inpatient & Outpatient)
- Free Clinic
- Home Health Agency
- Long Term Care (LTC) Facility
- Mental Health Inpatient Facility Rehabilitation Clinic
- Multi-Specialty Clinic
- Pediatric Subacute Care LTC
- Rehabilitation Clinic
- Skilled Nursing Facility
- Surgery Center (Non Physician-Owned) or Surgical Clinic
Provider Types Eligible to Enroll Through other Divisions/Departments
For the following services, programs, and providers, please follow the link to the relevant division/department site:
- AIDS Waiver Services (OA Medi-Cal Waiver Program (MCWP))
- Breast Cancer Early Detection Program (DHCS – Breast and Cervical Cancer Treatment Program)
- Care Coordinator Agency (DHCS – Integrated Systems of Care)
- California Children’s Services (CCS) /Genetically Handicapped Persons Program (GHPP) Institutional and Non-Institutional (DHCS – Integrated Systems of Care)
- Community-Based Adult Services (Department of Aging)
- Family Planning, Access, Care and Treatment (DHCS – Office of Family Planning)
- Home and Community Based Service Waivers (IDHCS – Integrated Systems of Care)
- Local Education Agency (Local Educational Agency Medi-Cal Billing Option Program | DHCS)
- Multi-Purpose Senior Services Program (Department of Aging)
- Residential Care Facilities for the Elderly (RCFE) (DHCS – Integrated Systems of Care)
- Rural Health Clinics (RHC)/Federally Qualified Health Clinic (FQHC) (DHCS – Audits and Investigations)