This page applies to nurse practitioners (NPs), certified nurse midwives, certified registered nurse anesthetists, and physician assistants (PAs).
To be recognized as a primary care provider with a panel of patients, submit the appropriate contracting application (for PA-PCPs or NP-PCPs).
To discontinue being a primary care provider with a panel of patients, submit the appropriate Contract Update form.
| For changes related to | You should |
|---|---|
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Complete the Contract Update Form for your provider type. |
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Submit a Standardized Provider Information Change Form. The Change Form is managed by the Mass Collaborative. |
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Update your CAQH Provider Data Portal (formerly ProView) record or submit a Standardized Provider Information Change Form. |
