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  • National provider identification (NPI): The NPI number is a ten-digit identification number, associated with individual physicians, including both solo and group practices.

 

  • BoredPractitioner License(s): An active medical license is required for every state in which you are practicing or intend to practice medicine. A list of previous or inactive medical licenses may also be requested.

 

  • Malpractice Insurance (Certificate of Insurance): Medical malpractice insurance protects healthcare professionals against claims alleging their negligent acts caused injury to patients.

 

  • DEA (federal) certificate and CDS (state)certificate

 

  • Board Certification(s): This information is required by every credentialing committee. Board certification ensures that physicians are meeting the highest standards set by their peers practicing in a medical specialty. It represents specialty-specific training beyond medical licensure.

 

  • Copy of highest level of education/ Diploma (required for non-MD’s, DO’s)
     

  • Updated CV: Make sure that you organized it chronologically and included crucial data like demographic, education and licensure, awards and honors, practice history and hospital affiliations, and peer-reviewed publications or presentations.

 

  • IRS Form W-9

 

  • Current driver’s license: A passport or other government-issued identification is an acceptable alternative. A passport-sized professional photograph may be requested to present in the early stage of your application.

 

  • Your Legal Entity

 

  • IRS form CP575 or replacement letter 147C (verification of EIN)

 

  • CLIA Certificate

 

  • Business License

 

  • Copy of office lease (required for therapy facilities)

 

  • Letter of bank account verification (for Medicare enrollment)

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