Providers must report changes in their provider information and status to MassHealth in writing as soon as possible.

Some changes in information or status that you must report to MassHealth Customer Services Center before the effective date of the change include:

  • ownership;
  • tax identification;
  • licensure;
  • organizational structure; and
  • other credentials, such as certifications or qualifications that may affect your eligibility to participate in MassHealth.

All other changes must be reported to MassHealth within 14 days. See MassHealth regulations at 130 CMR 450.223 pdf format of    regs_allprovider.pdf  for more information about provider contract requirements.

Download Change of Address Form

Send your updated information in writing to

MassHealth
Attn: Provider Enrollment and Credentialing
P.O. Box 9162
Canton, MA 02021
Fax: 617-988-8974

Include your MassHealth provider number and tax identification number on all correspondence. If you have any questions about the documentation that you should send, contact MassHealth Customer Services Center at 1-800-841-2900, send an e-mail to providersupport@mahealth.net, or send a fax to 617-988-8974.




This information is provided by MassHealth.