1915(i) Provider Enrollment

Medium

Prior to beginning the 1915(i) Provider Enrollment process, please reach out to nd1915i@nd.gov. There are many training and policy requirements involved with providing 1915(i) services, and the 1915(i) Administration Team strives to ensure providers are well informed, have a positive enrollment experience, and have the information and support they need to enjoy ongoing success. 

  • In order to provide 1915(i) services, an agency must first complete the group enrollment process for 1915(i), then also enroll individual providers to affiliate with their group. 
  • Group enrollment requires completion of steps 1-4 below. 
  • Individual enrollment requires the completion of steps 1-3 below. 

Group providers may affiliate individuals currently enrolled under a different group by submitting the SFN 1330 Request to Add an Affiliation Form linked below under the "Enrollment Resources" tab. Individuals may be affiliated with multiple group providers. If an individual leaves employment with an agency, the agency should complete the SFN 1331 Termination Form linked below under the "Enrollment Resources" tab.

Individual provider enrollment will not be approved without an affiliation to an existing, approved group. 

 

Medium

Obtain a National Provider Identifier (NPI) number. 

If a provider has previously been issued an NPI, they will not apply for a new one, rather they will need to ensure their existing NPI is updated to reflect the proper taxonomy codes for the services they will be enrolling to provide. 

 

For NPI login assistance, contact the Identity & Access System (I&A):

For assistance once logged in to the NPI system, contact the NPI Enumerator (available M-F 9am-5pm EST):

 

Find out if an NPI has been previously issued to an individual or organization here: Search the NPI Directory

 

 

 

 

 

Online Application

Provider Enrollment Online Application Guide

Find the Group and Individual Taxonomy Codes Here: Service Codes and Limits

Contact the ND Medicaid Provider Relations Call Center with questions or problems with the online application at (701) 328-7098, toll-free at (877) 328-7098, 711 TTY, or by emailing mmisinfo@nd.gov.

  • Obtain required forms by clicking on the links in the checklist
  • Complete the required forms
  • Sign any forms requiring a signature
  • Gather required documents from your files (such as licenses, federal tax letters, bank letters, etc.) – These vary depending on the type of service/services you will be providing
  • Submit all documents and forms to Provider Enrollment via email to NDMedicaidEnrollment@noridian.com, or by fax to (701) 433-5956.
  • Please refer to the Individual 1915(i) Provider Screening Policy for more information about background check requirements

Complete registration for the MCO Portal using the following link: MCO Information

Request a BCBSND contract for 1915(i) services by emailing: ProviderContracting@bcbsnd.com