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US · guidance

CMS Pub. 100-04, ch. 19, § 40.1.3

Multiple Sites

activein force · 2026-08-25 – presentas-observed

Multiple clinics utilizing the same TIN can be enrolled as practice locations under the

“owner” of the TIN (i.e., the hospital). Each clinic will be assigned a separate PIN. If the

clinic has a separate TIN, then the clinic would have to enroll separately. Payment is

made to the name associated with the TIN. The legal business name must be shown on

the Form CMS-855 exactly as it appears on the Internal Revenue Service documentation.

However, the “doing business as” name can be listed as the practice location.

History

(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
2515f8d4f78d66edde0857a9c4fff05da64d10b3622c7afc39e8ecae0b4cb852
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