Provider recredentialing 2026

1. Click ‘Get Form’ to open the provider recredentialing document in the editor.
2. Begin with Section 1: Demographic Data. Fill in your *Provider Name* and select the type of facility from the provided options. Ensure all required fields are marked with an asterisk.
3. Proceed to Section 2: Professional ID/Required Documents. Attach necessary documents such as accreditations and CMS certifications, ensuring you check all applicable boxes for your facility classification.
4. In Section 3: Address Data, provide your primary address and contact information. Make sure to indicate accessibility features and office hours accurately.
5. Complete Section 4: Facility Ownership and Staffing by listing ownership details and staffing information, including medical director credentials.
6. Finally, review Section 5 for application attachments and ensure all required documents are included before signing in Section 6.

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