New Mexico Medicaid Portal
Test Timeout to 10
Provider Enrollment Application
Create a New Application
Please enter your email address and click CREATE
Recall Your Existing Application
To recall an application that you have partially completed, enter your reference number and click RECALL
Forgot Your Reference Number?
If you have forgotten your reference number, please enter your email address below and click SUBMIT. The email address you submit will be validated against the one on file for you and your reference number will be sent to you by email.
Terms of Usage
Build Version: 3842-2017-03-08_07-31-19 - 194