Get Npi Provider Notification Form - Avmed - Avmed

Filling out the NPI Provider Notification Form is an essential step in registering your National Provider Identifier with AvMed Health Plans. This guide will provide you with detailed, step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the NPI Provider Notification Form and open it for editing.
2. Start by entering the provider's full name in the designated field. This includes the facility name or the individual physician's last name, first name, and middle initial.
3. Fill in the name of the contact person who will be responsible for communication regarding this registration.
4. Provide the telephone number for the contact person to ensure they can be reached easily.
5. Select the appropriate checkbox to identify the type of provider: Physician/Individual, Physician/Group, Facility, Ancillary Provider, or All other Providers.
6. Enter your 10-digit NPI number in the specified field. Make sure this number is accurate to avoid delays.
7. If you have AvMed Provider Numbers linked to this NPI, list them in the space provided.
8. Once you have completed all sections of the form, review your entries for accuracy.
9. Finally, you may save your changes, download, print, or share the completed form as needed. Ensure to mail or fax the form along with the NPI confirmation notice to AvMed Health Plans, or contact the Provider Service Center if you have any questions.

Complete your NPI Provider Notification Form online today and ensure your registration is submitted successfully.