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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