e6a630ada1
Verified firsthand against the live CMS-10114 (Rev. 02/25, OMB 0938-0931): - Section 1A confirms paper is valid for Change of Information (#2) AND Reactivation (#4), not just initial enumeration. Resolves the UNCERTAIN flag. - Current mailing address is CMS NPI Enumerator Services, Mail Stop DO-01-51, 7500 Security Blvd, Baltimore MD 21244. The old Fargo PO Box 6059 is retired; corrected in mac_routing.NPI_ENUMERATOR + all docs. - No electronic no-login equivalent exists for CMS (NPI Registry API is read-only; PECOS/NPPES-IA require login), unlike FMCSA's ask.fmcsa ticket form. So tiers stay: Standard=paper CMS-10114 (no login), Expedited=NPPES surrogate. New: cms10114_pdf_filler.py fills the flat official form via text overlay (reason checkbox + NPI + Section 2A identity + Section 4A cert name + signature anchor); wired into npi_provider._generate_10114_for_signing for nppes-update. Signed forms route to the NPI Enumerator via the existing daily batch. Tests: test_cms10114.py 27/27, test_paper_batch.py 15/15, Astro build 58 pages.
122 lines
6.1 KiB
Python
122 lines
6.1 KiB
Python
"""State -> Medicare Administrative Contractor (MAC) routing for CMS-855 mailing.
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CMS-855 paper applications are mailed to the provider's *designated MAC*, which is
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determined by the provider's STATE/jurisdiction (per the official 855I/855B/855O
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instructions: "The MAC that services your State is responsible for processing your
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enrollment application").
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This module maps each US state/territory -> its A/B MAC name + provider-enrollment
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mailing address. It is used to:
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1. Address the outgoing envelope for the Standard (paper) filing path.
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2. Group the daily batched mailing by destination agency (one Priority Mail
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envelope per MAC address).
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IMPORTANT — verify before first live mail run: MAC jurisdiction assignments and
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(especially) the provider-enrollment PO Box addresses change when CMS re-competes
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a jurisdiction. Confirm each MAC's current enrollment mailing address against the
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MAC's website / CMS.gov/Medicare/Provider-Enrollment-and-Certification right
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before the first batch, then keep this table the single source of truth.
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Jurisdiction assignments below reflect the long-standing A/B MAC map. Addresses
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are marked TODO where they must be filled from the MAC's current enrollment page.
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"""
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from __future__ import annotations
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from dataclasses import dataclass
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@dataclass(frozen=True)
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class MAC:
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key: str # short stable id (used for batch grouping)
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name: str # MAC contractor + jurisdiction
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# Provider-enrollment mailing address lines. VERIFY before live use.
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address_lines: tuple[str, ...]
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# A/B MAC jurisdictions (long-standing assignments). Addresses TODO-verify.
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NORIDIAN_JE = MAC("noridian_je", "Noridian Healthcare Solutions — Jurisdiction E",
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("Noridian Healthcare Solutions", "Provider Enrollment (JE)",
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"P.O. Box — VERIFY", "Fargo, ND — VERIFY"))
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NORIDIAN_JF = MAC("noridian_jf", "Noridian Healthcare Solutions — Jurisdiction F",
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("Noridian Healthcare Solutions", "Provider Enrollment (JF)",
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"P.O. Box — VERIFY", "Fargo, ND — VERIFY"))
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NOVITAS_JH = MAC("novitas_jh", "Novitas Solutions — Jurisdiction H",
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("Novitas Solutions", "Provider Enrollment (JH)",
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"P.O. Box — VERIFY", "Mechanicsburg, PA — VERIFY"))
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NOVITAS_JL = MAC("novitas_jl", "Novitas Solutions — Jurisdiction L",
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("Novitas Solutions", "Provider Enrollment (JL)",
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"P.O. Box — VERIFY", "Mechanicsburg, PA — VERIFY"))
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FCSO_JN = MAC("fcso_jn", "First Coast Service Options — Jurisdiction N",
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("First Coast Service Options", "Provider Enrollment (JN)",
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"P.O. Box — VERIFY", "Jacksonville, FL — VERIFY"))
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PALMETTO_JJ = MAC("palmetto_jj", "Palmetto GBA — Jurisdiction J",
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("Palmetto GBA", "Provider Enrollment (JJ)",
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"P.O. Box — VERIFY", "Columbia, SC — VERIFY"))
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PALMETTO_JM = MAC("palmetto_jm", "Palmetto GBA — Jurisdiction M",
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("Palmetto GBA", "Provider Enrollment (JM)",
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"P.O. Box — VERIFY", "Columbia, SC — VERIFY"))
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CGS_J15 = MAC("cgs_j15", "CGS Administrators — Jurisdiction 15",
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("CGS Administrators", "Provider Enrollment (J15)",
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"P.O. Box — VERIFY", "Nashville, TN — VERIFY"))
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WPS_J5 = MAC("wps_j5", "WPS Government Health Administrators — Jurisdiction 5",
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("WPS GHA", "Provider Enrollment (J5)",
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"P.O. Box — VERIFY", "Madison, WI — VERIFY"))
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WPS_J8 = MAC("wps_j8", "WPS Government Health Administrators — Jurisdiction 8",
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("WPS GHA", "Provider Enrollment (J8)",
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"P.O. Box — VERIFY", "Madison, WI — VERIFY"))
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NGS_J6 = MAC("ngs_j6", "National Government Services — Jurisdiction 6",
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("National Government Services", "Provider Enrollment (J6)",
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"P.O. Box — VERIFY", "VERIFY"))
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NGS_JK = MAC("ngs_jk", "National Government Services — Jurisdiction K",
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("National Government Services", "Provider Enrollment (JK)",
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"P.O. Box — VERIFY", "VERIFY"))
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# State (USPS) -> MAC. Based on the established A/B MAC jurisdiction map.
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STATE_TO_MAC: dict[str, MAC] = {
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# Noridian JE
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"CA": NORIDIAN_JE, "HI": NORIDIAN_JE, "NV": NORIDIAN_JE,
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"AS": NORIDIAN_JE, "GU": NORIDIAN_JE, "MP": NORIDIAN_JE,
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# Noridian JF
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"AK": NORIDIAN_JF, "AZ": NORIDIAN_JF, "ID": NORIDIAN_JF, "MT": NORIDIAN_JF,
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"ND": NORIDIAN_JF, "OR": NORIDIAN_JF, "SD": NORIDIAN_JF, "UT": NORIDIAN_JF,
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"WA": NORIDIAN_JF, "WY": NORIDIAN_JF,
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# Novitas JH
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"AR": NOVITAS_JH, "CO": NOVITAS_JH, "LA": NOVITAS_JH, "MS": NOVITAS_JH,
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"NM": NOVITAS_JH, "OK": NOVITAS_JH, "TX": NOVITAS_JH,
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# Novitas JL
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"DE": NOVITAS_JL, "DC": NOVITAS_JL, "MD": NOVITAS_JL, "NJ": NOVITAS_JL,
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"PA": NOVITAS_JL,
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# First Coast JN
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"FL": FCSO_JN, "PR": FCSO_JN, "VI": FCSO_JN,
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# Palmetto JJ
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"AL": PALMETTO_JJ, "GA": PALMETTO_JJ, "TN": PALMETTO_JJ,
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# Palmetto JM
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"NC": PALMETTO_JM, "SC": PALMETTO_JM, "VA": PALMETTO_JM, "WV": PALMETTO_JM,
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# CGS J15
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"KY": CGS_J15, "OH": CGS_J15,
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# WPS J5
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"IA": WPS_J5, "KS": WPS_J5, "MO": WPS_J5, "NE": WPS_J5,
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# WPS J8
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"IN": WPS_J8, "MI": WPS_J8,
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# NGS J6
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"IL": NGS_J6, "MN": NGS_J6, "WI": NGS_J6,
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# NGS JK
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"CT": NGS_JK, "ME": NGS_JK, "MA": NGS_JK, "NH": NGS_JK,
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"NY": NGS_JK, "RI": NGS_JK, "VT": NGS_JK,
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}
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# NPI Enumerator paper address (NPPES / CMS-10114 paper path) — not a MAC, but a
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# destination the daily batch groups by, same as a MAC.
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# VERIFIED 2025 against CMS-10114 (Rev. 02/25), OMB 0938-0931, page 5 "Or send the
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# completed signed application to:". The earlier Fargo, ND PO Box 6059 address is
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# RETIRED; the current address printed on the form is the Baltimore one below.
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NPI_ENUMERATOR = MAC(
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"npi_enumerator", "NPI Enumerator (NPPES / CMS-10114 paper)",
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("CMS NPI Enumerator Services", "Mail Stop DO-01-51",
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"7500 Security Blvd.", "Baltimore, MD 21244"),
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)
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def mac_for_state(state: str) -> MAC | None:
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"""Return the designated MAC for a USPS state code, or None if unknown."""
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return STATE_TO_MAC.get((state or "").strip().upper())
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