Apply for Medicaid Online in the State of Nevada using this service.
At a minimum, you must submit the required attachments listed on the Checklist for the provider type you are trying to enroll. Please refer to the Checklist for your specific provider type and provider specialty for documentation requirements. In addition, the following item is required: • Electronic Funds Transfer (EFT) Authorization – New or revised EFT information
The Provider Enrollment Unit will contact the Contact Person listed on the online application if additional information is needed to process your application.
To return to the application, go to the Online Provider Enrollment Portal and select the “Resume Enrollment” link. On the Resume Enrollment page, enter the tracking number, Federal Employer Identification Number (FEIN) or Social Security Number (SSN) and password for the saved application. Note: If forgotten, the password cannot be reset and your request is no longer available. You will need to begin a new request
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