Provider Address Change Information

Is your address changing? Please report your changes as soon as possible to prevent delays in receiving Medicaid payments and policy updates.

• Submit changes online, by mail, fax or email:
  • Online: Contact Us
  • Mail:
    Department of Social Services
    Division of Medical Services
    Provider Enrollment
    700 Governors Drive,
    Pierre, SD 57501-2291
  • Fax: 605-773-5246
  • E-mail: medical@state.sd.us
• Submit the following information:
  • Provider name
  • Medicaid and/or NPI number
  • Federal Tax Identification number
  • Old address/New address (Is this the practice location or billing location?)
  • Contact Person
  • Contact Phone Number