License Navigator
Your comprehensive guide to licensing, credentialing, and provider enrollment. Streamline the complex process of getting credentialed and ready to practice.
Credentialing Essentials
Credentialing is the process of verifying your qualifications to practice medicine and bill insurance companies. It's required by employers, hospitals, and payers before you can see patients and receive reimbursement for your services.
The credentialing process typically takes 90-180 days and requires multiple steps. Starting early and staying organized can significantly reduce delays in starting your new position.
Credentialing Checklist for New Grads
Get Your NPI
Apply for National Provider Identifier before your first job
1-2 weeksState Licensure
Apply for state license(s) in your practice state(s)
4-12 weeksDEA Registration
Apply for DEA if you will prescribe controlled substances
4-6 weeksCreate CAQH Profile
Set up your credentialing profile and upload documents
2-3 hoursMedicare Enrollment
Enroll in PECOS if billing Medicare (or opt out)
60-90 daysVerify Clean Records
Check OIG LEIE and NPDB to ensure no adverse actions
15 minutesEssential Credentialing Resources
NPI Registry (NPPES)
Obtain and verify your National Provider Identifier
Key Features:
- ✓Apply for new NPI
- ✓Update existing NPI information
- ✓Verify NPI for other providers
- ✓Download taxonomy codes reference
Pro Tips:
💡 All healthcare providers must have an NPI. Apply early before starting your first job. Use taxonomy codes: 363LF0000X (NP), 363A00000X (PA).
PECOS (Medicare Enrollment)
Enroll in Medicare to bill for services or opt out
Key Features:
- ✓Medicare enrollment application
- ✓Revalidation tracking
- ✓Reassignment of benefits
- ✓Opt-out affidavit submission
Pro Tips:
💡 Required if you will bill Medicare. Revalidation required every 5 years. Enrollment can take 60-90 days, so start early.
CAQH ProView
Centralized credentialing profile for payers and hospitals
Key Features:
- ✓Single credentialing profile
- ✓Shared with multiple payers
- ✓Digital document upload
- ✓Re-attestation reminders
Pro Tips:
💡 Most employers require CAQH. Keep your profile updated and re-attest every 120 days. Upload high-quality scans of all certificates.
OIG LEIE (Exclusion List)
Verify you are not excluded from federal healthcare programs
Key Features:
- ✓Instant exclusion search
- ✓Monthly CSV downloads
- ✓Historical exclusion data
- ✓Reinstatement information
Pro Tips:
💡 Employers check this before hiring. Run a search on yourself and save the verification PDF. Also check state Medicaid exclusion lists.
Nursys QuickConfirm
Primary-source license verification for nurses and APRNs
Key Features:
- ✓Real-time license verification
- ✓Multi-state license lookup
- ✓Compact license status
- ✓Disciplinary action disclosure
Pro Tips:
💡 Free verification service for nursing licenses. Note: Not all states participate. Check your state board website if not listed.
Additional Resources
State Medical Boards
- FSMB State Medical Board Directory →
Find PA licensing boards and verification portals
- NCSBN Board of Nursing Directory →
Contact information for state boards of nursing
Federal Resources
- DEA Diversion Control →
Apply for DEA registration to prescribe controlled substances
- National Practitioner Data Bank →
Self-query your NPDB report annually ($2 fee)
Credentialing Pro Tips
📝Before You Start
- •Create a "credentialing folder" with copies of all certificates
- •Scan documents at 300 DPI for clear, readable uploads
- •Keep digital and physical copies of everything
- •Set up a professional email address (not Gmail) if possible
⚡Staying Organized
- •Track all expiration dates in a calendar
- •Re-attest CAQH every 120 days to avoid profile expiration
- •Update all systems within 30 days of any changes
- •Run OIG LEIE check quarterly for peace of mind