An official website of the United States government
The PIN Request Summary page gives you the final opportunity to review and edit your Personal Identification Number (PIN) Request information and Authorized Representative (AR) Information. The summary page displays this information in read-only format but with Edit buttons to return to the selected pages.
Be sure that ALL of the information is correct on this page before you click Continue. You will not be able to change any information once the PIN Request has been submitted.
To Edit Your PIN Request Information
- Click Edit in the PIN Request section to return to the PIN Request page. The page will be prefilled with your current information.
- Make any necessary edits; then click Continue to navigate back to the PIN Request Summary page.
To Edit Your Authorized Representative (AR) Information
- Click Edit in the AR Information section to return to the AR Information page. The page will be prefilled with your current information.
- Make any necessary edits; then click Continue to navigate back to the PIN Request Summary page.
To Submit Your Information
If all information is correct, click Continue to submit the data and continue to the PIN Request Thank You page or click Cancel to display the Cancel Confirmation page.
From the Cancel Confirmation page, click Cancel to redisplay the PIN Request Summary page with all information intact; or click Continue to return to the Welcome to the CRCP page with no information saved.
A federal government website managed and paid for by the U.S. Centers for Medicare and Medicaid Services.
7500 Security Boulevard, Baltimore, MD 21244