I’m affiliated with a Group or a Individual provider. How do I add this affiliation to my enrollment?

If you have the provider’s NPI, FEIN, SSN, or first & last name that you are affiliated with, this information can be used to affiliate with this provider if they are already enrolled in Medicaid. As an Individual provider affiliating with a Group, enter either the NPI, FEIN, or Group name into the search bar within the Taxonomy/License/Affiliation section of the enrollment application. As a Group provider affiliating with an Individual provider, enter either the NPI, SSN, or first & last name of the provider in the search bar within the Affiliation section. Select Add when the correct provider appears.

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