Provider Index > Managed Care Plan
Provider Enrollment & Maintenance
A NYS certified health insurance plan or system that coordinates the provision, quality and cost of care for its enrolled members
Complete this Enrollment Form if you are: - Applying for initial ENROLLMENT or ALREADY ENROLLED and enrolling another NPI, or
- Responding to a letter instructing you to REVALIDATE your enrollment, or
- Seeking REINSTATEMENT or REACTIVATION of your previous enrollment, or
- Reporting an OWNERSHIP CHANGE, or
- Reporting a RECEIVERSHIP
INSTITUTION Enrollment Form