Provider Credentialing Document Guide

Welcome! This guide is designed to help you gather the documents commonly needed for provider credentialing. Each item below includes a short explanation of its purpose. If you’re unsure whether a document applies to you, or if you have questions, please reach out to your credentialing support contact for guidance.

Tip: Not every document will be relevant to every provider. If you don’t have a particular item or aren’t sure what it is, just ask for help.

Identification & Legal Documents

• Government-issued Photo ID Confirms your identity (e.g., driver’s license or passport).

• Social Security Card Verifies your Social Security number for identification and tax purposes.

• Recent Photograph Used for identification in credentialing files.

• Permanent Resident Card/Green Card/Visa Proof of legal eligibility to work in the U.S. (for non-citizens).

Professional Numbers & Licenses

• National Provider Identifier (NPI) Unique number for healthcare providers in the U.S.

• Medicaid and Medicare Numbers Identifies you for billing government insurance programs.

• UPIN Number Medicare billing identifier (if applicable).

• Federal Tax ID Number Used for tax reporting and billing.

• State Medical License(s) Proof you’re licensed to practice in the relevant state(s).

• DEA Registration Certificate Authorizes you to prescribe controlled substances.

• State Controlled Substance Registration State-specific authorization to prescribe controlled substances (if required).

Education & Training

• Medical School Diploma Shows you graduated from an accredited medical school.

• Training Certificates (Internship, Residency, Fellowship) Proof of completed postgraduate training.

• Board Certification(s) Documentation of specialty board certification.

• ECFMG Certificate For international medical graduates, verifies U.S. equivalency.

Professional Experience

• Curriculum Vitae (CV) Chronological record of your professional history.

• Work History List of all practice locations and employment affiliations.

• Hospital Privileges Documentation Proof of current or past hospital privileges.

• Delineation of Privileges Form Specifies the clinical privileges you request at a facility.

• Case Logs/Surgical Logs Record of procedures performed (for certain specialties).

Insurance & Legal

• Malpractice Insurance Certificate Proof of current professional liability insurance.

• Malpractice Claims History Record of any malpractice claims or suits.

References & Continuing Education

• Letters of Recommendation References from peers who have observed your clinical work.

• Continuing Medical Education (CME) Certificates Proof of CME activities completed in the past three years.

Certifications & Health Records

• Basic/Advanced Life Support Certifications (BLS/ACLS/ATLS/PALS/NRP) Certificates for required life support and emergency training.

• Immunization Records and TB Test Results Documentation of up-to-date immunizations and tuberculosis screening.

Additional Documents

• National Practitioner Data Bank (NPDB) Report Report of any disciplinary actions, malpractice payments, or adverse actions.

• Military Discharge Record (DD-214) Proof of honorable discharge from military service (if applicable).

Remember: If you’re missing a document, aren’t sure if it applies, or need help, your credentialing support team is here to assist you. It’s normal to have questions—just ask!