Some changes in information or status that you must report to MassHealth Customer Service before the effective date of the change include:
- tax identification;
- 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 for more information about provider contract requirements.
Download Change of Address Form
Send your updated information in writing to
Attn: Provider Enrollment and Credentialing
P.O. Box 9118
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 Service at 1-800-841-2900, send an e-mail to email@example.com, or send a fax to 617-988-8974.
This information is provided by MassHealth.