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)
Audiologist
Blood Bank
Certified Mastectomy Fitter
Certified Nurse Midwife
Certified Nurse Practitioner
Certified Nurse Practitioner Group
Certified Registered Nurse Anesthetist
Chiropractor
Christian Science Practitioner
Clinical Laboratory
Clinical Nurse Specialist 
Community-Based Organization (for CHW and AP services)
County Clinic Not Associated with Hospital Exempt From Licensure
Dental Group
Dentist
Developmental Screening and Trauma 
Diabetes Prevention Program
Dispensing Optician
Doctor of Medicine
Doctor of Osteopathic Medicine
Doula
Doula Group
Drug Medi-Cal Clinic
Drug Medi-Cal Clinic Medical Director
Drug Medi-Cal Heroin Detox
Drug Medi-Cal Licensed Substance Use Disorder Treatment Professional
Drug Medi-Cal Substance Use Disorder Medical Director
Durable Medical Equipment
Exempt from Licensure Clinic
Fabricating Optical Laboratory
Hearing Aid Dispenser
Hospice Providers for Palliative Care Services 
Independent Diagnostic Testing Facility (IDTF)
Licensed Clinical Social Worker
Licensed Clinical Social Worker Group
Licensed Individual Drug Medi-Cal Clinic Professional
Licensed Marriage and Family Therapist
Licensed Marriage and Family Therapist Group
Licensed Midwife
Licensed Professional Clinical Counselor
Licensed Professional Clinical Counselor Group
Local Health Jurisdiction (for CHW and AP services)
Medical and Non-Medical Ground Transportation
Nurse Practitioner (Supervised)
Occupational Therapist
Ocularist
Optometrist
Optometrist Group
Orthotist
Outpatient Heroin Detox Center
Out of State Hospital (Inpatient)
Out of State Hospital (Outpatient)
Pharmacy/Pharmacist
Physician Assistant (Supervised)
Physician/Surgeon
Physician/Surgeon (Group)
Physical Therapist
Podiatrist
Portable Imaging
Prosthetist
Prosthetist/Orthotist Group
Psychologist
Psychologist Group
Registered Dental Hygienists
Registered Dental Hygienists in Alternative Practice
Registered Dental Hygienists in Extended Functions 
Respiratory Care Practitioner
Respiratory Care Practitioner Group
Speech Language 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:

Adult Day Health Care (ADHC) Center
Alternative Birth Centers – Specialty Clinic
Birthing Center Services
Blood Bank
Certified Hospice
Chronic Dialysis Clinic
Community Clinic
Community Hospital (Inpatient)
Community Hospital (Outpatient)
County Clinics Not Associated with Hospital
County Hospital (Inpatient)
County Hospital (Outpatient)
Free Clinic
Health Access Program
Heroin Detox Clinic
Home Health Agency
Home and Community Based Services Nursing Facility
Hospice
Long Term Care Facility
Mental Health Inpatient Facility Rehabilitation Clinic 
Multi-Specialty Clinic
Otherwise Undesignated Clinic
Pediatric Subacute Care LTC
Rehabilitation Clinic
Residential Care Facilities for the Elderly (RCFE)
Rural Health Clinics/Federally Qualified Health Clinic
Surgery Center (Physician-Owned and 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 (DHCS – Office of AIDS)
Breast Cancer Early Detection Program (DHCS – Breast and Cervical Cancer Treatment Program)
Care Coordinator Agency (DHCS – Integrated Systems of Care)
CCS/GHPP Institutional (DHCS – Integrated Systems of Care)
CCS/GHPP Non-Institutional (DHCS – Integrated Systems of Care)
Community-Based Adult Services (Department of Aging)
Electronic Health Records Incentive Program (DHCS – Health Information Management Division)
Employment Agency (DHCS – Safety Net Financing)
EPSDT Supplemental Services Provider (DHCS – Integrated Systems of Care) 
Expanded Access to Primary Care Clinic (DHCS – Primary and Rural Health Division)
Genetic Disease Testing (DHCS – Benefits Division)
HCBS Benefit Program (DHCS – Integrated Systems of Care)
Home and Community-Based Services Nursing Facility (Home and Community-Based Alternatives Waiver [HCBA]-Congregate Living Health Facility [CLHF]) (DHCS – Safety Net Financing)
Indian Health Services (DHCS – Primary and Rural Health Division)
Individual Nurse Providers (DHCS – Integrated Systems of Care)
Local Education Agency (DHCS – Safety Net Financing)
Mental Health Inpatient Services (DHCS – Mental Health Services)
Multi-Purpose Senior Services Program (Department of Aging)
Personal Care Agency (DHCS – Integrated Systems of Care)
Private Non-Profit Proprietary Agency (DHCS – Integrated Systems of Care)
Professional Corporation (DHCS – Integrated Systems of Care)
Unified School District (DHCS – Integrated Systems of Care)