Resources

Industry Hubs To Improve Your Credentialing Life Cycle

The following resources are for you to conduct your own research into the credentialing life cycle.
Please use as frequently as needed.

General
Education
Federal Government
Insurance Companies
Medical Academies, Associations and Societies
Medical Licensing
Specialty Boards
Medical Specialty Colleges
Medical Resources
Non-Physician Organizations

 

General

Council for Affordable Healthcare (CAQH) – http://www.caqh.org/

American Accreditation Healthcare Commission / URAC – http://www.urac.org/

American Health Information Management Association – http://www.ahima.org/

American Hospital Association – http://www.aha.org/aha_app/index.jsp

American Medical Association – http://www.ama-assn.org/

American Medical Association Masterfile Request – https://profiles.ama-assn.org/amaprofiles/

American Medical Group Association –
http://www.amga.org/

American Osteopathic Association –
http://www.osteopathic.org/

American Podiatric Medical Association – http://www.apma.org/s_apma/index.asp

FACIS Homepage – http://www.facis.com/

Federated Ambulatory Surgery Association – http://www.ascassociation.org/

Federation of State Medical Boards –
http://www.fsmb.org/

Health Financial Management Association –
http://www.hfma.org/

Healthcare Quality Certification Board CPHQ –
http://www.cphq.org/

Joint Commission on Accreditation of Healthcare Organizations / JCAHO – http://www.jointcommission.org/

Medical Group Management Association –
http://www.mgma.com/

National Association for Healthcare Quality –
http://www.nahq.org/

National Association Medical Staff Services –
http://www.namss.org/

National Board of Medical Examiners –
http://www.nbme.org/

National Medical Association – http://www.nmanet.org/

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Education

Accreditation Council for Graduate Medical Education – http://www.acgme.org/acWebsite/home/home.asp

Educational Commission for Foreign Medical Graduates (ECFMG) – http://www.ecfmg.org/

National Student Clearinghouse – http://www.nslc.org/

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Federal Government

Centers for Medicare & Medicaid Services – CMS – http://www.cms.gov/default.asp

Core Privileges – Dept of the Navy – http://www-nmcp.med.navy.mil/msso/coreprivileges.asp

Drug Enforcement Administration – DEA – http://www.justice.gov/dea/index.shtml

Drug Enforcement Administration Database –
http://www.deanumber.com/

Drug Enforcement Administration Diversion Control Program – http://www.deadiversion.usdoj.gov/

DHHS Excluded Individuals/Entities (Searchable) – http://exclusions.oig.hhs.gov/search.aspx

Federal Register –
http://www.gpoaccess.gov/fr/index.html

FedWorld Information Network – http://www.fedworld.gov/

First Gov – US Government – http://www.usa.gov/

Food and Drug Administration – FDA –
http://www.fda.gov/

General Accounting Office – http://www.gao.gov/

National Practitioner Data Bank/Healthcare Integrity and Protection Data Bank/IQRS
http://www.npdb-hipdb.org/

National Technical Information Service – DEA Database Subscription Information –
http://www.ntis.gov/Index.aspx

OSHA – Occupational Safety & Health Administration – http://www.osha.gov/

National Plan & Provider Enumeration System (NPPES) – https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do

Office of Inspector General – http://oig.hhs.gov/

UPIN # Lookup – http://upin.ecare.com/

US Dept of Justice ADA Home Page – http://www.ada.gov/

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Insurance Companies

Aetna (800) 624-0756 – http://www.aetna.com/provider/medical/index.html

Affinity (866) 247-5678 – https://www.affinityplan.org/Affinity/Providers/Providers.aspx

Americhoice   (877) 842 3210 –
http://www.americhoice.com/

Atlantis (866) 747-0877 –
http://www.atlantishp.com/index.asp

Cigna (800) 832-3211 – http://www.cigna.com/customer_care/healthcare_professional/medical/index.html

Elderplan (718) 921 7979 – http://www.elderplan.org/index.php?option=com_content&task=view&id=73&Itemid=

Empire Blue Cross Blue Shield FAST CHECK: 800-992-2583 – http://www.empireblue.com/home-providers.html

Empire Plan  (877) 769-7447 – http://www.empireplanproviders.com/

Fidelis (888) FIDELIS – (888) 343-3547 – http://www.fideliscare.org/providers.aspx

GHI (212) 501-4444 – http://www.ghi.com/Providers.aspx

Healthfirst (888) 801-1660 – http://www.healthfirstny.com/provider/provider_services.html

Healthnet (800) 438-7886 – https://www.healthnet.com/portal/provider/home.do

Healthplus (800) 450-8753 – http://www.healthplus-ny.org/en/3725_ENG_HTML.html

HIP (212) 630-8711 –
https://www.hipusa.com/providers/ny/provider.asp

Local 1199 National Benefit Fund (646) 473 9200 – http://www.1199nbf.org/forproviders/default.aspx

Magnacare (800)235-7267 – http://www.magnacare.com/providers/providers.aspx

Medicare (877) 869-6504 – http://www.ngsmedicare.com/ngsmedicare/HomePage.aspx

Medicaid (800) 343-9000 – http://www.emedny.org/

Multiplan (212) 780-2000 –
http://www.multiplan.com/providers/

Neighborhood Health Providers (800) 558-7970 –
http://www.getnhp.com/

Oxford Health Plans (800) 666-1353 – Oxford HMO/Freedom/Liberty/Medicare Advantage
https://www.oxhp.com/cgibin/corporate/auth/auth_nav.pl?User=PHYSICIAN;App=LOGIN

Palmetto GBA (888) 355-9165 – http://palmettogba.com/nsc

Touchstone Health (888) 777-0350 For prior authorizations (888) 777-0263 – https://www.touchstone-health.com/providers/

Unicare (877) UNICARE (877)-864-2273 – http://www.unicare.com/home-providers.html

United Healthcare (877) 842-3210 – https://www.unitedhealthcareonline.com/b2c/CmaAction.do?viewKey=PreLogin

Value Options  (800) 888-3944 – http://www.valueoptions.com/providers/Providers.htm

Wellcare (866)530-9491 –
http://www.wellcare.com/provider/default

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Medical Academies, Associations and Societies

Aerospace Medical Association – http://www.asma.org/

American Academy of Allergy Asthma & Immunology – http://www.aaaai.org/

American Academy of Child & Adolescent Psychiatry – http://www.aacap.org/

American Academy of Cosmetic Surgery – http://www.cosmeticsurgery.org/

American Academy of Dermatology – http://www.aad.org/

American Academy of Family Physicians – http://www.aafp.org/online/en/home.html

American Academy of Hospice & Palliative Medicine – http://www.aahpm.org/

American Academy of Insurance Medicine –
http://www.aaimedicine.org/

American Academy of Neurology – http://www.aan.com/

American Academy of Ophthalmology – http://www.aao.org/

American Academy of Orthopaedic Surgeons –
http://www.aaos.org/

American Academy of Otolaryngic Allergy –
http://www.aaoaf.org/

American Academy of Otolaryngology – Head and Neck Surgery – http://www.entnet.org/

American Academy of Pain Medicine –
http://www.painmed.org/

American Academy of Pediatrics – http://www.aap.org/

American Academy of Pharmaceutical Physicians –
http://www.aapp.org/

American Academy of Physical Medicine & Rehabilitation – http://www.aapmr.org/

American Academy of Sleep Medicine –
http://www.aasmnet.org/

American Association for Hand Surgery –
http://www.handsurgery.org/

American Association for Thoracic Surgery –
http://www.aats.org/

American Association of Clinical Endocrinologists – http://www.aace.com/

American Association of Clinical Urologists –
http://www.aacuweb.org/

American Association of Hip & Knee Surgeons – http://www.aahks.org/

American Association of Neurological Surgeons –
http://www.aans.org/

American Association of Plastic Surgeons –
http://www.aaps1921.org/

American Association of Public Health Physicians – http://www.aaphp.org/

American Clinical Neurophysiology Society –
https://www.acns.org/

American Gastroenterological Association –
http://www.gastro.org/

American Geriatrics Society –
http://www.americangeriatrics.org/

American Institute of Ultrasound in Medicine –
http://www.aium.org/

American Medical Directors Association –
http://www.amda.com/

American Orthopaedic Association –
http://www.aoassn.org/

American Orthopaedic Foot and Ankle Society –
http://www.aofas.org

American Pediatric Surgical Association – http://www.eapsa.org//AM/Template.cfm?Section=Home

American Psychiatric Association – http://www.psych.org/

American Society for Aesthetic Plastic Surgery – http://www.surgery.org/

American Society for Clinical Pathology –
http://www.ascp.org/

American Society for Gastrointestinal Endoscopy – http://www.asge.org/

American Society for Reproductive Medicine –
http://www.asrm.org/

American Society for Surgery of the Hand – http://www.assh.org/Pages/default.aspx

American Society for Therapeutic Radiology and Oncology – http://www.astro.org/

American Society of Anesthesiologists – http://www.asahq.org/sitemap.htm

American Society of Bariatric Physicians – http://www.asbp.org/%20target=

American Society of Cataract and Refractive Surgery – http://www.ascrs.org/

American Society of Clinical Oncology – http://www.asco.org/portal/site/ascov2

American Society of Cytopathology – http://www.cytopathology.org/website/article.asp?id=2531

American Society of General Surgeons –
http://www.theasgs.org/

American Society of Hematology –
http://www.hematology.org/

American Society of Maxillofacial Surgeons –
http://www.maxface.org/

American Society of Neuroimaging – http://www.asnweb.org/i4a/pages/index.cfm?pageid=1

American Society of Neuroradiology –
http://www.asnr.org/

American Society of Ophthalmic Plasticand Reconstructive Surgery – http://www.asoprs.org/home.cfm

American Society of Plastic Surgeons –
http://www.plasticsurgery.org/

American Telemedicine Association – http://www.americantelemed.org/i4a/pages/index.cfm?pageid=1

American Thoracic Society – http://www.thoracic.org/

Association of Military Surgeons of the United States – http://www.amsus.org/

Association of University Radiologists –
http://www.aur.org/

Contact Lens Association of Ophthalmologists –
http://www.clao.org/

National Association of Medical Examiners –
http://thename.org/

North American Spine Society – http://www.spine.org/Pages/default.aspx

Radiological Society of North America –
http://www.rsna.org/

Society for Investigative Dermatology –
http://www.sidnet.org/

Society of American Gastrointestinal Endoscopic Surgeons – http://www.sages.org/

Society of Critical Care Medicine – http://www.sccm.org/Pages/default.aspx

Society of Interventional Radiology –
http://www.sirweb.org/

Society of Medical Consultants to the Armed Forces – http://www.smcaf.org/

Society of Nuclear Medicine – http://interactive.snm.org/index.cfm?pageid=10&rpid=1977

Society of Radiologists in Ultrasound –
http://www.sru.org/

Society of Thoracic Surgeons – http://www.sts.org/

United States & Canadian Academy of Pathology – http://www.uscap.org/home.htm

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Medical Licensing

Alabama Board of Medical Examiners –
http://www.albme.org

Alaska State Medical Board –
http://www.dced.state.ak.us/occ/pmed.htm

Arizona State Board of Medical Examiners –
http://www.azmd.gov/

Arkansas State Medical Board –
http://www.armedicalboard.org/

California Medical Board – http://medbd.ca.gov/

Colorado State Board of Medical Examiners – http://www.dora.state.co.us/medical/

Connecticut Licensing Information – http://www.ct.gov/dph/site/default.asp

Florida Division of Medical Quality Assurance – Licensure and Certification
http://www.doh.state.fl.us/

Florida Department of Health Care Provider Information – http://ww2.doh.state.fl.us/irm00praes/praslist.asp

Georgia Composite State Board of Medical Examiners – http://gov.georgia.gov

Hawaii Division of Professional and Vocational Licensing – http://hawaii.gov/dcca/pvl

Idaho Board of Medicine –
http://bom.idaho.gov/BOMPortal/Home.aspx

Illinois Department of Professional Regulation – http://www.idfpr.com/

Indiana Health Professions Bureau – http://www.in.gov/ai/errors/pla_404.html

Kansas Board of Healing Arts – http://www.ksbha.org/

Kentucky Board of Medical Licensure –
http://kbml.ky.gov/

Louisiana State Board of Medical Examiners – http://www.lsbme.louisiana.gov/

Maryland Board of Physician Quality Assurance – http://www.mbp.state.md.us/

Massachusetts Board of Registration in Medicine – http://www.massmedboard.org/

Michigan Department of Consumer and Industry Services – License Verification
http://www.dleg.state.mi.us/verify.htm

Minnesota Board of Medical Practice – http://www.state.mn.us/portal/mn/jsp/home.do?agency=BMP

Mississippi State Board of Medical Licensure – http://www.msbml.state.ms.us/

Nebraska Department of Regulation and Licensure – http://www.hhs.state.ne.us/lis/lisindex.htm

Nevada State Board of Medicine – http://medboard.nv.gov/

New Hampshire State Board of Medicine – Physician Finder – http://www4.egov.nh.gov/medicineboard/

New Jersey State Office of Attorney General – Physician Search – http://www.state.nj.us/cgi-bin/consumeraffairs/search/searchentry.pl?searchprofession=2501

New Jersey State Health Professional Licensing – http://www.nj.gov/lps/ca/boards.htm

New Mexico Board of Medical Examiners –
http://www.nmmb.state.nm.us/

New York Office of the Professions-Medical Licensing – http://www.op.nysed.gov/

New York On-line License Verification – http://www.op.nysed.gov/opsearches.htm#licno

North Carolina Board of Medical Examiners – http://www.ncmedboard.org/

North Dakota State Board of Medical Examiners – http://www.ndbomex.com/

Ohio State Medical Board – http://med.ohio.gov/

Oklahoma State Board of Medical Licensure & Supervision – http://www.okmedicalboard.org/

Oregon State Board of Medical Examiners –
http://www.oregon.gov/

Pennsylvania State Board of Medicine – http://www.dos.state.pa.us/portal/server.pt/community/bureau_of_professional___occupational_affairs/12483

South Carolina Department of Labor, Licensing and Regulation – License Look
up – http://www.llr.state.sc.us/pol.asp

Tennessee Department of Health – License Verification – http://health.state.tn.us/

Texas State Board of Medical Examiners – http://reg.tmb.state.tx.us/OnLineVerif/Phys_NoticeVerif.asp

Utah Division of Occupational & Professional Licensure – http://dopl.utah.gov/

Vermont Board of Medical Practice –
http://healthvermont.gov/

Virginia Department of Health Professions – http://www.dhp.state.va.us/

Washington State Department of Health – Licensing and Certification – http://www.doh.wa.gov/

West Virginia Board of Medicine License Directory – http://www.wvbom.wv.gov/

Wisconsin Department of Regulation and Licensing – http://drl.wi.gov/Index.asp

Wyoming Board of Medicine –
http://wyomedboard.state.wy.us/roster.asp

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Specialty Boards

American Board of Allergy and Immunology – https://www.abai.org/index.asp

American Board of Anesthesiology –
http://www.theaba.org/

American Board of Dermatology – http://www.abderm.org/

American Board of Emergency Medicine –
http://www.abem.org/public/

American Board of Family Practice –
https://www.theabfm.org/

American Board of Internal Medicine –
http://www.abim.org/

American Board of Medical Genetics –
http://www.abmg.org/

American Board of Medical Specialties –
http://www.abms.org/

American Board of Neurological Surgery – http://www.abns.org/content/default.asp

American Board of Obstetrics and Gynecology –
http://www.abog.org/

American Board of Ophthalmology –
http://www.abop.org/index1.asp

American Board of Orthodontics (non-ABMS) – http://www.americanboardortho.com/

American Board of Otolaryngology – http://www.aboto.org/

American Board of Pathology – http://www.abpath.org/

American Board of Pediatrics – https://www.abp.org/

American Board of Plastic Surgery – https://www.abplsurg.org/Moddefault.aspx

American Board of Podiatric Surgery (non-ABMS) –
http://www.abps.org/

American Board of Psychiatry and Neurology –
http://www.abpn.com/

American Board of Radiology – http://www.theabr.org/

American Board of Surgery – http://home.absurgery.org/default.jsp?index

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Medical Specialty Colleges

American College of Allergy, Asthma, & Immunology – http://www.acaai.org/Pages/default.aspx

American College of Cardiology – http://www.acc.org/

American College of Chest Physicians –
http://www.chestnet.org/accp/

American College of Emergency Physicians – http://www.acep.org/

American College of Gastroenterology –
http://www.acg.gi.org/

American College of Medical Genetics – http://www.acmg.net//AM/Template.cfm?Section=Home3

American College of Medical Quality –
http://www.acmq.org/

American College of Nuclear Medicine –
http://www.acnmonline.org/

American College of Obstetricians and Gynecologists – http://www.acog.org/index.cfm

American College of Occupational and Environmental Medicine – http://www.acoem.org/

American College of Osteopathic Internists –
http://www.acoi.org/

American College of Physician Executives – http://www.acpe.org/acpehome/index.aspx

American College of Physicians –
http://www.acponline.org/

American College of Preventive Medicine –
http://www.acpm.org/

American College of Radiation Oncology –
http://www.acro.org/

American College of Radiology –
http://www.acr.org/flash.html

American College of Rheumatology –
http://www.rheumatology.org/

American College of Surgeons – http://www.facs.org/

College of American Pathologists –
http://www.cap.org/apps/cap.portal

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Medical Resources

Centers for Disease Control and Prevention CDC –
http://www.aapa.org/

Journal of the American Medical Association JAMA – http://jama.ama-assn.org/

National Cancer Institute –
http://www.cancer.gov/

National Library of Medicine (Includes MedLine Search) – http://www.nlm.nih.gov/

New England Journal of Medicine –
http://content.nejm.org/

Modern Healthcare – http://www.modernhealthcare.com/

WHO – World Health Organization – http://www.who.int/en/

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Non-Physician Organizations

American Academy of Physician Assistants –
http://www.aapa.org/

American Board of Professional Psychology – http://www.abpp.org/i4a/pages/index.cfm?pageid=3285

American Nurses Credentialing Center –
http://www.nursingworld.com/

American Psychological Association – http://www.apa.org/

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