Insurance Credentialing Information Required

The insurance credentialing process can feel overwhelming, especially if you’re new to the process. To help get things started, please create and save an easily sharable list that contains the following information:

Insurance Credentialing Information Required:

  • Name

  • Address

  • Gender

  • Preferred Pronoun(s)

  • Date of Birth

  • Phone

  • Email

  • Languages Spoken

  • Degree

  • Licensure Type

  • Wisconsin License #

  • NPI #

  • Medicaid Provider ID #

  • Taxonomy

  • Specialty

  • SSN #

  • CAQH ID #

Be mindful that these requirements may be subject to change. As a matter of good practice, we recommend keeping this information readily accessible and frequently reviewed for continuing accuracy.

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