PACE Organization Membership

PACE Organization Membership Application

Your Individual Contact Information

Member Organization Profile Information

The preferred name that the organization uses to market itself to the general public.

This is the address that will geo-locate in our online PACE Finder, which helps drive enrollment referrals from visitors to our website looking for their local PACE.

This is generally a main administrative office phone number.

If you have a different phone number for enrollment inquiries, list that here. This is the phone number we will use for the general public in our online PACE Finder.

Do you also have an enrollment/marketing specific email that you would like us to include for referrals? This is normally something like info@pace.org or referrals@pace.org.

What type of legal structure does your PACE organization have?

This is a number, typically in the format H1234, that is assigned by the Centers for Medicare & Medicaid Services (CMS).

Staff List for Membership Benefits

Our memberships are done on an organizational basis. Once your organization is approved as a member, all of the benefits of membership are available to your entire staff. In order for them to take advantage of their member benefits, they'll just need an NPA account.

How would you like to add your staff?

Other Staff Contacts

This field is required

If you are creating a list, we'll need the same information that we asked for you above (full name, postnominal, job title, email, preferred direct phone number). Or, if it's easier for you, feel free to upload an existing staff roster. Word and excel files preferred, but we can also accept PDF files.

Current State of PACE Program

This information is optional, but helps us to better serve you and your organization's particular needs.

Ready to Submit?
I accept NPA's member code of conduct.*

I accept NPA's antitrust policy and guidelines.*

If your state has a chartered state PACE association, NPA has a mutual membership agreement. NPA and SPAs work closely together.*

PACE "multis" are defined as 3 or more PACE organizations delineated by CMS H number, which are under common control (ownership of 50% or more) OR common management (defined as consolidated authority over financial decision-making). If my PACE program/H number is part of a "multi", I understand that all must be a member of NPA for me to be eligible.*

Your membership application must first be approved, and then you will be invoiced. NPA's annual membership year runs from July 1-June 30. If you apply during the year, your membership will be pro-rated for the rest of the membership year, and billed annually thereafter. Membership in NPA will not begin until payment in full is received. Membership is non-refundable. Please signal your acceptance by checking "yes" below.*

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