Caqh provider data sheet 2026

1. Click ‘Get Form’ to open the CAQH Provider Data Sheet in the editor.
2. Begin by filling out the top portion of the form. Enter your Last Name, First Name, Middle Initial, Social Security Number, and Date of Birth. Ensure all personal information is accurate.
3. Next, provide your Primary Office Address details including License Number, License State, Street, City, State, Phone, Fax, and Zip Code. Double-check for any typos to avoid delays.
4. Once completed, fax the top portion back to CareFirst at 410-872-4107 as instructed. Wait for your CAQH ID Number which will be sent back to you.
5. After receiving your CAQH ID Number, access the CAQH website to complete your online application. If you lack internet access, contact the CAQH Help Desk for alternative options.
6. Finally, after completing the CAQH application and gathering required attachments and authorizations, fax this form along with a completed Authorization Form and Practice Questionnaire back to CareFirst.

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