An official website of the United States government
The User Profile page allows you to change your personal information that is associated with your login ID.
The page initially opens with the fields pre-filled. Make changes as needed and click Save. Click Cancel to return to the previous page without making changes.
Fields online with an asterisk (*) are required.
| Field | Description |
|---|---|
| Personal Information | - |
| First Name | First name. May contain letters A-Z or a-z. Use only alpha characters or embedded spaces. |
| Last Name | Last name. May contain letters A-Z or a-z, hyphens, apostrophes, and embedded spaces. |
| Job Title | Job title. May contain letters A-Z or a-z, hyphens, apostrophes, and embedded spaces. |
| Mailing Address | - |
| Street 1 | Primary street number and street name. |
| Street 2 | Secondary street address. Use for attention to, apartment number, or suite number. (optional) |
| City | City name. |
| State | Use the drop-down menu to select the state. For foreign RREs, select “Foreign Country” from the State drop-down menu. The rest of the address fields are not required. |
| Zip Code | Five-digit U.S. postal code and ZIP+4 extension (optional). |
| Contact Information | - |
| E-mail Address | Email address. |
| Confirm E-mail Address | Re-enter email to confirm. |
| Telephone | Phone number including area code and extension (optional). |
| Fax | Facsimile phone number including area code (optional). |
September 2024
A federal government website managed and paid for by the U.S. Centers for Medicare and Medicaid Services.
7500 Security Boulevard, Baltimore, MD 21244