This resource center helps providers, clinics, and patients understand how healthcare credentials are verified in the United States, including what information is publicly available and what is protected by law.
Federal and state credentialing requirements explained in clear, operational terms.
Direct access to CMS, state, and commercial payer credentialing and enrollment forms.
Recredentialing schedules, sanctions monitoring, and audit readiness guidance.
Answers to common credentialing, enrollment, and compliance questions.
Use this index to locate official credentialing and enrollment forms commonly required by government programs and commercial payers.
| CMS Form | Purpose | Applies To | Source |
|---|---|---|---|
| CMS-855I | Medicare enrollment for individual providers | Physicians / NPPs | CMS Forms Directory |
| CMS-855B | Medicare enrollment for groups & practices | Group Practices | CMS Forms Directory |
| CMS-855A | Facility Medicare enrollment | Hospitals | CMS Forms Directory |
| CMS-855R | Reassignment of Medicare benefits | Reassignments | CMS Forms Directory |
| CMS-588 | Electronic Funds Transfer setup | Payments | CMS Forms Directory |
Compliance Note: CMS restricts direct PDF and deep-link access. Links intentionally route to the official CMS Forms Directory to ensure availability, accuracy, and regulatory compliance.
| Check Type | Public? | Where |
|---|---|---|
| State License | ✅ Yes | USA.gov – State License Lookup |
| Medicare Enrollment | ✅ Yes | CMS NPI Registry |
| Board Certification | ✅ Yes |
Confirms provider’s specialty training and expertise.
Learn about healthcare credentials (USA.gov) |
| National Practitioner Data Bank (NPDB) | 🔒 No | HHS NPDB (Information Only) |
| Hospital Privileges | 🔒 No | Hospital Medical Staff Office |
Compliance Note: Certain credentialing data, including NPDB reports and hospital privileges, is restricted under U.S. federal regulations and available only to authorized healthcare organizations.
Download documents checklist required for provider enrollment, credentialing, and recredentialing for individuals.
Download pdf format ⟶ 
Checklist
Download documents checklist required for provider enrollment, credentialing for groups/individuals starting new practice.
Download pdf format ⟶ Checklist