Your Complete Physician Credentialing Guide

In healthcare, provider credentialing makes sure physicians are qualified to perform medical procedures. It’s critical. Protects the facility. Protects the provider.

But it’s complicated. Time-consuming. Requires submitting tons of documents. Hard to track sometimes. That’s why we created this physician credentialing checklist to help speed things up.

Wait a sec! Before diving in, let’s be clear why this matters.

Following the credentialing process properly optimizes billing and coding workflows. Reduces payment delays. Improves revenue cycle management. Keeps your practice running smoothly.

Table of Contents

Physician Credentialing Checklist: Step-by-Step Guide

The US has 50 states. Each has its own rules for healthcare provider credentialing. So, the first step? Check your state laws. Credentialing takes time. A lot of it. Submitting documents, verifications it can take 90–150 days.

If you’re a new provider starting your career, start early. The sooner, the better. Here’s a breakdown of the stages to complete credentialing:

Stage #1 – Pre-Application Submission

Think of this as a background check. It covers:

Criminal records
Disciplinary actions
Board certification

This stage helps the credentialing board filter out unqualified providers. They may request additional documents if any issues pop up. Don’t worry if you’re qualified, no flags. You’ll pass and move on smoothly.

Stage #2 – Application Submission

Now, you submit the official credentialing application. Include all required information and supporting documents. Requirements vary—physician, nurse, provider assistant, or group.

We’ll provide a detailed checklist later in this guide. Keep reading to uncover it. Or skip straight to that section if you prefer.

Stage #3 – Verification of Receipt

After submitting, follow up. Call or email to confirm receipt. The board may request more information. Provide it promptly to avoid delays.

Also, keep copies of your application and all submitted documents. Trust us—it helps.

Credentialing Documents Checklist for New Physicians

If you’re a new physician ready to start practicing, follow this checklist. Essential. No shortcuts.

ACLS/BLS certification
Case logs from the last 24 months (if applicable)
Professional liability insurance certificate or policy page (if applicable)
Complete work history with all employment affiliations and practice locations
Locum tenens practice experience form (if applicable)
Current immunization records and recent TB test results (if available)
Active state license wallet cards
Certificates: NRP, ACLS, ATLS, BLS, APLS, or PALS
Board certificate with issuing board details and certification dates
State-controlled substance registrations or the federal DEA
FLEX, NBME, SPEX, or USMLE scores
NPI confirmation letter and documentation
Wall certificate with expiration date and number
CME activity for the past three years
DEA certificate
Driver’s license
Federal tax ID number
Green card, permanent resident card, or visa for non-US residents
Hospital privileges documents
ECFMG certificate info (for foreign graduates)
Last ten years’ insurance claims report
Malpractice claims history
Personal contact details
Privilege form completed delineation
Residency diploma
Recently signed photograph
Social security card
Surgical logs
Third-party documentation for disciplinary/malpractice actions (if applicable)
Three recommendation letters from healthcare providers who observed you within the last year
Updated CV with complete chronological professional history
UPON number

Credentialing Documents Checklist for Advanced Practice Registered Nurses & Physician Assistants

If you’re an APRN or PA, the checklist is similar, with a few differences.

Ongoing professional practice evaluation
Case logs from the last 24 months (if applicable)
Locum tenens practice experience form (if applicable)
Most recent TB test results and immunization records
Active state license wallet cards
College/university diploma and training certificates
Federal DEA and state-controlled substance registrations
NPI confirmation letter and documentation
Wall certificate with expiration date and number
CME activity for the past three years
Diploma and transcripts
Driver’s license
Federal tax ID number
Focused professional practice evaluation
Military discharge record, DD-214 (if applicable)
Personal contact details
Practice history with employment affiliations and facility locations
Privileges form completed delineation
Recently signed photograph
Social security card
Three professional recommendation letters
Updated CV with complete chronological professional history

Credentialing Documents Needed for a Group Practice

Now that we’ve covered individual providers, PAs, and registered nurses, let’s talk about group practices.

When applying as a group, each physician submits their documents in one application. Each provider must meet the credentialing board’s requirements for the group to be approved.

Bank letter with branch contact name and phone OR a voided check
Commercial liability insurance for the group and DME with NSC added
Hours of operation (Monday–Friday, Saturday/Sunday)
Articles of incorporation for the group
IRS letter – CP575
NPPES registry screenshot showing the group NPI
Owner’s board certification (if a provider)
Owner’s DEA license (if a provider)
Owner’s medical degree certificate (if a provider)
Owner’s copy of social security card or driver’s license
Owner’s social security number
Group start date
W-9 form with tax ID

Bottom Line

Still feeling overwhelmed? Outsource it. Professionals like MedyraTech handle credentialing for providers, groups, nurses, and PAs.

Outsourcing is smart. Credentialing isn’t continuous. Physicians gain skills, certifications, and need updates to stay qualified. Avoid penalties.

Healthcare facilities also benefit. Staff changes. New physicians require credentialing. Payment delays? Avoided. Time saved. Stress reduced.

Your Complete Physician Credentialing Guide