Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Social Security Administration (SSA) before sending sensitive documents. FaxFlow is not affiliated with this organization.
Social Security Administration (SSA) fax number
(833) 914-2016
Medicare Enrollment / Special Enrollment Period (Part B)
Used for: Fax CMS-40B and CMS-L564 forms for Medicare Part B enrollment to SSA local offices via toll-free fax number 1-833-914-2016
Fax destination details
- Department
- Medicare Enrollment / Special Enrollment Period (Part B)
- Purpose
- Fax CMS-40B and CMS-L564 forms for Medicare Part B enrollment to SSA local offices via toll-free fax number 1-833-914-2016
- Form
- CMS-40B; CMS-L564 — CMS-40B: Application for Enrollment in Medicare Part B; CMS-L564: Request for Employment Information
- Voice phone
- 1-800-772-1213
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill CMS-40B to enroll in Part B; CMS-L564 to document employer information when enrolling during a Special Enrollment Period. Fax the completed forms to SSA using the toll-free number 1-833-914-2016, or submit by mail/online as directed by SSA/CMS.
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