Optum provider update form 2026

1. Click ‘Get Form’ to open the Optum Provider Update Form in the editor.
2. Begin by reviewing your current demographic information online to ensure accuracy. This will help you identify any necessary changes.
3. Fill out Section 1, which includes required information such as your last name, first name, and Tax Identification Number (TIN). Ensure that all details match your records.
4. If you are adding a new TIN, complete the W-9 form and check the appropriate box for 'Add New TIN'. If deleting an existing TIN, ensure at least one active TIN remains.
5. For demographic changes, complete Sections 1 and 2 along with any relevant sections. Be sure to provide accurate practice location information.
6. Review all entries for accuracy before signing. Once completed, submit the signed form and any attachments to your Network Management Team as instructed.

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