Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 217 - Vision Services
Chapter 1 - General
Rule 23-217-1.2 - Provider Enrollment
Universal Citation: MS Code of Rules 23-217-1.2
Current through September 24, 2024
A. Providers of vision services, and those who dispense optical items such as eyeglasses and contacts must satisfy all requirements set forth in Part 200, Chapter 4, Rule 4.8 in addition to the following provider type specific requirements:
1. National Provider Identifier (NPI),
verification from National Plan and Provider Enumeration System
(NPPES),
2. Copy of licensure card
or letter from the appropriate board stating current certification. Card or
letter must be from state of servicing location, and
3. Verification of social security number
using a social security card, driver's license if it notes the social security
number, military ID or a notarized statement signed by the provider noting the
social security number. The name noted on verification must match the name
noted on the W-9.
B. Written confirmation from the IRS confirming the provider's tax identification number and legal name.
Miss. Code Ann. § 43-13-121; 42 CFR 455, Subpart E
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