Provider Credentialing Document Guide

Last updated January 23, 2026

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.

  • 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).
  • 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!