help_bullet_title.gif Provider Search & Selection

 

Select an Existing Provider

  1. Select a name from the available drop-down list of previously used providers available in the support file. Due to space constraints, only the first 15 characters of the " LastName, FirstName MiddleName" will be displayed.

  2. Confirm the correct physician was selected by reviewing the Contact Information and Provider Type displayed.

  3. If the provider is not correct, click <<Change Provider and either select a different provider from the list or search for the provider in the master provider file (see Search for a Medicaid Provider below).

  4. If the provider is correct, either continue on to the next Provider type or the next tab.

Search for a Medicaid Provider

  1. Enter the physician's full Last Name OR National Provider ID or the Medicaid ID into the appropriate fields and click Go to search the database of NY Medicaid Providers. NOTE: Entering the provider's Last Name followed by a single space and the provider's first name will help narrow the list of providers with a common last name.

  2. If multiple providers are returned, a table will display containing all the matches, select the desired physician and click Select Provider.

  3. If a single provider matches the name or ID entered, the single record will display, click Select Provider and continue.

  4. If no providers match the name or ID entered, the error message "Provider Not Found" will be displayed.

  5. If providers were returned but none are the desired physician or if no providers match the name or ID entered, this may be due to a typographical error in the search criteria, if so click Change Provider and try again, otherwise you will need to Enter a New Non-Medicaid Provider.

Enter a New Non-Medicaid Provider

Fill out the fields with the appropriate amount of information that you have for the physician. This data will be validated against the support file for potential matches based on the information that you enter, to avoid duplication of data. Duplication is based on the State License Number and SSN, if entered.

Last Name: A last name must be entered when entering any type of physician, Person or Non-Person. If the Provider is identified as a Non-Person Entity, such as an organization, then the entire Organization name will be entered here and the First Name and Middle Initial fields will remain blank.

First Name: This is the first name of the selected physician, however is only required if the Person radio button was selected.

Middle Initial: The middle initial is optional for all physician types; if entered, it will assist in differentiating multiple physicians with common first and last names.

EIN or SSN: Either the EIN or the SSN is required if a Last Name is entered. The setting of the radio button will determine which is to be entered. Valid entries must be 9 digits and may be entered with or without the appropriate dashes.

NPI# AND/OR State License #: NPI# AND/OR State License # is required if Last name entered. Enter either the National Provider ID or the State License #, or enter Both. For State License Number : Enter the 3-digit Profession Code, 2-character State Code (out of state providers) or Privilege Code (in state providers) and 6-digit license for a total of 11 characters. If the license number does not equal 6-digits, zero-fill the appropriate positions preceding the license number.