For Providers: What is Provider Enrollment and Change Self-Service?
Provider Enrollment and Change Self-Service is an application for group administrators within the provider portal.
With it, you can update your information with us and enroll new practitioners within your group.
Group administrators who maintain data for health care practitioners and allied provider groups can use this app.
These professional health care practitioner groups include:
Allied provider groups include:
Only those with Type 2 NPIs who are responsible for maintaining group information with us should register for this app. Independent practitioners who aren’t part of a group or facility providers can’t use this self-service app.
Here's a list of services you can complete with this application based on your provider type:
You'll need to have access to the provider portal. Not yet registered? Learn how to get an account.
Once you have access, you'll need to fill out and send us this form: