Maryland Medical Programs Web Services
... brought to you by the Maryland Department of Health and Mental Hygiene
Enroll as a Medical Care Provider in Maryland's Medicaid Program
Welcome to our site!  If you are a healthcare provider, you may be eligible to apply on-line for participation in Maryland's Medicaid Program.
 If you are not a healthcare provider, please visit our Home Page.
 If you are a Personal Care Aide, you must contact your Local Health Department to apply for participation in Maryland's Medicaid Program.
Before beginning the application process, please provide the following information:
(As the person completing this form, you are required to enter your own name and contact information. Do not enter the Provider's name unless you yourself are the Provider.)
Your First Name:
Your Last Name: 
Your Phone Number:  - - ext.
Your Job Title:
Your relationship to the Provider who is applying:
I am the provider.
I am an employee of the Provider.
I am not an employee, but I am an
authorized representative of the Provider.
To begin the application process, please select the Provider Type which corresponds to the type of healthcare services that you provide:

If you do not see your Provider Type in this list, please contact Medicaid Provider Enrollment.
  This site provides documents in Adobe Acrobat format.
To access these documents, you must download and
install the Adobe Acrobat Reader software.