EPS NPI Addendum - UnitedHealthcareOnline.com 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by selecting whether you want to register an NPI number or set up an NPI level bank account. Fill in the date, TIN number, organization name, and contact details including first name, last name, email address, phone number, and title.
  3. Enter your NPI number and NPI name. If you are setting up a bank account for payments, provide the financial institution's name, address (street, city, state/province), telephone number, routing number, and type of account (checking or savings).
  4. Complete the provider’s account number with the financial institution and ensure to include a voided check or bank letter as required. Tape the voided check in the designated area on the form.
  5. Review all entered information for accuracy before submitting. Once completed, fax or mail your form along with any necessary documents to the specified address.

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