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Integrated massachusetts application for initial credentialing

Massachusetts credentialing i 2026

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The document is an Integrated Massachusetts Application for Initial Credentialing/Appointment, which collects comprehensive personal, educational, and professional information from medical professionals seeking credentialing and appointment at healthcare facilities. It includes sections on personal data, office information, board certification, education history, work history, licensure details, military commitments, professional references, liability insurance coverage, and various disclosures regarding disciplinary actions and malpractice claims. The application aims to ensure that applicants meet the necessary qualifications and standards for medical practice.

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Click ‘Get Form’ to open the Massachusetts Credentialing I in the editor.
Begin with Section I – Personal Information. Fill in your last name, first name, middle name, and professional title. Ensure all fields are completed accurately.
Provide your current home address and local area home address if different. Include apartment number, street address, city, state, and zip code.
Enter your contact information including phone numbers and email addresses. Specify languages spoken and any alternate email addresses.
Complete the sections on specialty and sub-specialty by indicating the percentage of practice dedicated to each.
Fill out the education section chronologically, listing all schools attended beyond high school along with their complete mailing addresses.
Review all sections for accuracy before submitting. Use our platform's features to save your progress or share it for collaboration if needed.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the Massachusetts Physician credentialing Initiative?

The Massachusetts Physician Credentialing Initiative establishes a standardized process for physician credentialing by health plans and hospitals.

How to verify a physicians license in Massachusetts?

You will need the health professionals license number and/or last name. If you have any difficulty navigating the search pages, call the Health Professions License Verification Help Desk at (617) 973-0800. If you get a recorded message, please leave a detailed message.

Whats the difference between credentialing and licensing?

Program Requirements Be authorized to conduct business in Massachusetts. Be an agency that delivers health and human services to seniors or disabled populations. Be equipped to accept MassHealth payments in full for all Adult Foster Care services. Evaluate, train and support the Adult Foster Care caregiver.

What is the main purpose of provider credentialing?

Provider credentialing is a way of verifying and assessing the professional qualifications of physicians and healthcare practitioners. Its a thorough investigation of a practitioners background, including education, training , licensure, certifications, experience, and disciplinary history.

What is the Massachusetts physician Act?

The act allows internationally-trained physiciansindividuals who completed a residency overseasto obtain a one-year limited license to practice under mentorship at participating healthcare facilities, which include federally qualified health centers, community centers, and hospitals in physician shortage areas that

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How do I become an AFC provider in Massachusetts?

For any outstanding questions, please contact MassHealth Customer Service at (800) 841-2900, TTY/TDD: 711 or provider@masshealthquestions.com.

What is the physician pathway program Massachusetts?

The Physician Pathway Act (PPA) replaces the license requirement with a supervised practice program. The PPA pathway substitutes a 1-year assessment and evaluation program at a participating healthcare facility, where the ITP would practice under a limited license.