Application for a Medicare provider number and/or prescriber number for a medical practitioner form (HW019)

Use this form to apply for an initial or additional Medicare provider number or a prescriber number, or both.

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

Download and complete the Application for a Medicare provider number and/or prescriber number for a medical practitioner form.

You can also apply for Medicare Provider Numbers using Health Professional Online Services (HPOS).

When applying online, you’ll need a PRODA account to use HPOS.

Learn about Applying for additional Medicare Provider Numbers and How to apply for a provider number if you’re a medical intern.

Make sure you submit your application and supporting documentation to us before your proposed location start date.

Page last updated: 12 December 2025.
QC 20526