Required Information for Credentialing
"Advocate. Market. Elevate."

Required Information for Credentialing:

  • CAQH login and password.
  • Curriculum Vitae. MUST include month/year and all employment.
  • Medical License(s), DEA and State Controlled Substances (CDS) Certificates;
  • Board Certificate(s).
  • Professional Liability Insurance page.
  • Documents regarding all settled, dismissed and (or) pending malpractice claims.
  • NPI Letter, number, login and password.
  • Copy of social security card, medical school diploma and other training diplomas.
  • CME certificates; and letters for all current hospital privileges.
  • Group information including: IRS letter, Tax ID, voided check, address, phone, fax, billing information and NPI letter, login and password

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