Completed Medicare Part A Enrollment Applications with an original signature should be sent to:

CareFirst of Maryland, Inc.
Medicare Part A
Attention: Jessica Jaworski
Provider Enrollment
1946 Greenspring Drive
Timonium, Maryland 21093

FAX NUMBER 410-561-7926

(DO NOT FAX ENROLLMENT APPLICATIONS)

NOTE - Include copies of the following if applicable:
CLIA Certificates
FDA Mammography Certificates
Diabetes Education Certificates

If application is for a Change of Ownership please include Transfer/Sales Agreement.