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 and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology or need an interpreter.

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: 27 June 2025.
QC 20526