Clinicians: Keep directory information current
Your updates are critical, so members have the most accurate information. Even if your information is accurate today, please be sure to submit changes as they arise throughout the year.
Important fields:
- Medical groups
- Hospital affiliations
- Board certification
- Languages spoken
- Whether you are accepting new patients
For other changes, choose a category below.
For changes to your
- Physical and mailing addresses
- Phone number
Go to CAQH to update your recredentialing application. You also need to complete the Standardized Provider Information Change Form.
To make changes related to
- Tax ID
- Practice billing updates
- Joining/opening a new practice
- Hospital affiliations or privileges
- Adding a product to an existing contract
Complete the Contract Update Form for Physician Assistants and Ancillary Advanced Practice Nurses.
To be recognized as a primary care provider with a panel of patients
Complete the PA-PCP and NP-PCP Contracting Application.
To make changes related to
- Tax ID
- Practice billing updates
- Joining/opening a new practice
- Hospital affiliations or privileges
- Adding a product to an existing contract
Complete the Contract Update Form for Nurse Practitioner-PCPs and Physician Assistant-PCPs.
To discontinue being a primary care provider with a panel of patients
Complete the Contract Update Form for Physician Assistants and Ancillary Advanced Practice Nurses.
For contract terminations or closing/re-opening your PCP panel
Complete the Standardized Provider Information Change Form.
For changes to your
- Physical and mailing addresses
- Phone number
Go to CAQH to update your recredentialing application. You also need to complete the Standardized Provider Information Change Form.
For changes related to
- Tax ID
- Practice billing updates
- Joining/opening a new practice
- Hospital affiliations or privileges
- Adding a product to an existing contract
Complete the Contract Update Form for Ancillary Professional Providers.
- Note: If you’re newly licensed as a different provider type, you will need a new contract. Submit a contracting application.
For contract terminations
Complete the Standardized Provider Information Change Form.
If you’re newly licensed as a different type of Ancillary Professional
Complete a contracting application.
Diagnostic imaging services
| If you | Then |
|---|---|
| Have professional privileges | No new professional privileging application is required. |
| Have technical privileges but are moving, adding a site, or joining a new practice | You must submit a Limited Technical Privileging Application for your new location. |
| Are not currently approved for either professional or technical privileging | Go to the Privileging page and download the applicable privileging application. |
For more information about privileging, visit our Privileging page.
To make clinical updates to our online directory
Complete the Clinical Profile Form.
For changes to your
- Physical and mailing addresses
- Phone number
Go to CAQH to update your recredentialing application. You also need to complete the Standardized Provider Information Change Form.
For changes related to
- Tax ID
- Joining/opening a new practice
- Adding a product to an existing contract
Complete the Contract Update Form for Behavioral Health Professionals.
- Note: If you’re newly licensed as a different provider type, you will need a new contract. Submit a contracting application.
For contract terminations
Complete the Standardized Provider Information Change Form.
If you’re newly licensed as a different type of behavioral health professional
Complete a contracting application.
For changes to your
- Physical and mailing addresses
- Phone number
Go to CAQH to update your recredentialing application. You also need to complete the Standardized Provider Information Change Form.
For changes related to
- Primary care status
- Tax ID
- Practice billing updates
- Joining/opening a new practice
- Hospital affiliations
- Adding a product to an existing contract
Complete the Contract Update Form for Physicians.
If you're not credentialed by us and you're
- Joining or opening a new practice
Complete the HCAS Enrollment Form and the Physician Group Application (Type 2 NPI required).
For contract terminations and closing/re-opening your PCP panel
Complete the Standardized Provider Information Change Form.
If you are becoming a concierge practice
Review our concierge practice fact sheet.
For changes related to
- Physical and mailing address
- Phone number
- Adding or closing a service site
- Tax ID
- Ceasing business or will no longer provide services in Massachusetts
- Reporting a new DBA (doing business as name)
- Recontracting with us
- Providing new services
- Adding a product to an existing contract
- All other changes
Complete the Update Form for Facilities.
