Individual Provider Credentialing
✔ Covers single clinicians (MDs, DOs, NPs, etc.)
✔ Required Documents:
- Personal licenses (state, DEA)
- Individual NPI (Type 1)
- Malpractice insurance
✔ Best For: Solo practitioners, locum tenens
Group Practice Credentialing
✔ Covers entire organization (clinics, hospitals)
✔ Additional Requirements:
- Group NPI (Type 2)
- Tax ID/EIN verification
- Organizational contracts
✔ Benefits: - Single approval for multiple providers
- Streamlined payer contracting
Key Considerations
- Medicare: Requires both individual (855I) and group (855B) enrollment
- Commercial Payers: Some require individual applications even for groups
- Timeline: Group credentialing often takes longer (60-120 days)
