Provider Maintenance Information

Provider Enrollment is responsible for reviewing and approving updates submitted by providers. All new maintenance and updates are now completed using the KY Medicaid Partner Portal Application (KY MPPA). In the KY MPPA, Providers can view the current information KY DMS has on file and make updates as needed. Providers are responsible for keeping their information up to date with Kentucky Medicaid.​

Please notify Provider Enrollment of any changes to provider name, address, ownership, etc., by contacting:

Kentucky Medicaid
Provider Enrollment
P.O. Box 2110,
Frankfort, KY 40602

 

​Forms

MAP-347, the Statement for Authorization of Payment,Group Linkages Section form

MAP-529, KY Medicaid Change of Information Form 

Contact Information

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