The short answer: These items come from the pages named beside each one. Payers and provider types differ, so check each payer's own list. Each item below says who asks for it and for whom. A few apply only to dentists or to one state.
Key takeaways
- Every item below names the page that lists it and the providers it covers.
- DataSpring says CAQH profiles are attested every 120 days, or every 180 days for Illinois providers.
Before you gather anything: how to share documents
DataSpring, powered by CAQH, says in its privacy policy (effective September 29, 2026) that email transmissions may not be secure.
Please don't send your Social Security number, DEA registration, license documents, or other sensitive documents through our web forms or by email.
How to read this checklist
The pages do not match each other. Cigna's page lists board certification. The Blue Cross and Blue Shield of Montana page lists a W-9. Neither appears on every page we checked. Treat each line as that source's list, for the providers it names.
The documents and numbers payers ask for
Your NPI, and keeping the NPPES record current
CMS says covered health care providers must obtain a National Provider Identifier (NPI) and use it in all HIPAA transactions. A covered provider is one that sends health information electronically in a standard transaction. CMS says other providers are eligible to get one (CMS Unique Identifiers FAQs, last modified March 16, 2026).
The ADA's credentialing checklist for dentists (version dated 07.06.23) lists the dentist's individual NPI number.
CMS says a covered provider must notify NPPES of an address change within 30 days of the effective date. 45 CFR 162.410(a)(4) says a covered health care provider must communicate any changes in its required data elements to the National Provider System within 30 days of the change (eCFR, current as of October 23, 2026).
Type 1 versus Type 2 NPIs get their own post.
State license
Cigna's provider credentialing page lists a valid, unrestricted state medical license or appropriate professional license among the information it asks for in its application packet (page checked October 23, 2026).
Anthem's New York provider page lists a current license to practice in each state where services are provided as part of a complete application (page checked October 23, 2026).
The ADA's credentialing checklist for dentists (version dated 07.06.23) lists the dentist's state license number or numbers.
DEA and CDS certificates, if you hold one
Cigna's page lists a Drug Enforcement Administration (DEA) certificate. Cigna's page says one is "needed for each practicing state." It also lists a Controlled Dangerous Substances (CDS) certificate "if required by the state" (page checked October 23, 2026).
Anthem's New York provider page lists a current DEA or CDS certificate in each state as part of a complete application.
Blue Cross and Blue Shield of Montana's page lists a DEA certificate among materials it calls "helpful to reference while applying" (page checked October 23, 2026).
Education, training and board certification
Cigna's page lists professional education and training, including training in the specialty applied for. It also lists board certification status, by the American Board of Medical Specialties or the American Osteopathic Association (page checked October 23, 2026).
Anthem's New York provider page lists education and training as part of a complete application. The ADA's checklist for dentists lists education and training information.
Work history, with gaps explained
Cigna's page says work history must include the previous five years, with an explanation for gaps greater than six months.
Anthem's New York provider page lists five years' work history in month/year format as part of a complete application.
Professional liability insurance, claims history and sanctions
Cigna's page lists adequate malpractice insurance that meets the applicable state and medical specialty requirements. It also lists malpractice claims history. Cigna's page lists prior sanctioning activities, by applicable regulatory bodies and CMS, and says they must be disclosed on the application.
Anthem's New York provider page lists current professional liability insurance as part of a complete application.
Blue Cross and Blue Shield of Montana's page lists, among materials it calls "helpful to reference while applying," a malpractice insurance face sheet and a summary of any pending or settled malpractice cases.
Hospital privileges, if you have them
Cigna's page lists clinical privileges at a Cigna-participating hospital, in good standing on the medical staff. It has a separate form for providers who do not have them.
Anthem's New York provider page lists current hospital privilege information.
Practice locations
Blue Cross and Blue Shield of Montana's page lists previous and current practice locations among materials it calls "helpful to reference while applying". The ADA's checklist for dentists lists practice location information.
Other items one plan lists
Blue Cross and Blue Shield of Montana's page lists, among materials it calls "helpful to reference while applying," a curriculum vitae, IRS Form W-9 and a previously completed credentialing application (page checked October 23, 2026).
For Texas physicians and other professional providers whose provider type is not on its CAQH-approved list, Blue Cross and Blue Shield of Texas's page lists a curriculum vitae, a signed attestation and, for nurse practitioners only, a written protocol to send with the Texas Standardized Credentialing Application (page checked October 23, 2026).
Documents and details to double-check
Examples of documents that can be missing or incorrect, in no particular order: malpractice certificates, licenses, W-9s, work history or CVs, and NPI or practice details that are inconsistent. This is a list of examples, not a ranking.
Your CAQH Provider Data Portal (formerly ProView) profile
CAQH profile steps: documents, attestation and plan authorization
DataSpring describes the steps. Complete the profile and upload documents such as a license, training certificates and liability insurance. Attest that the information is truthful and complete. Then authorize plans or other organizations to access the profile (page checked October 23, 2026).
Cigna's page says that if you apply through CAQH, authorize Cigna to access your data and review the profile for changes. It asks that the profile show the status Initial Profile Complete or Re-attestation.
Aetna's Join the Aetna Network page says that, if credentialing applies, Aetna gets the credentialing application from CAQH. It asks providers to designate Aetna as an authorized health plan (page checked October 23, 2026).
For help setting up or keeping a profile current, see our CAQH setup and maintenance page.
Re-attest every 120 days (180 for Illinois providers)
DataSpring says providers attest to their profiles every 120 days, or every 180 days for Illinois providers. It says a profile that is not attested in time changes to Expired.
For dentists: expiring-document reminders
DataSpring's dental FAQ says reminders encourage dentists to review and attest to their information every 120 days, and that the system prompts users if licenses or other documentation is about to expire. The ADA says the system is designed to send email reminders when the next re-attestation date is approaching or when certain documents are set to expire.
Medicare: the enrollment form
CMS says Medicare enrollment can be done online in PECOS. CMS lists the CMS-855I paper form for physicians and non-physician practitioners. It says Forms CMS-588 and CMS-460 are routinely submitted with an enrollment application (CMS Enrollment Applications page, last modified March 4, 2026).
CMS says a paper application needs a handwritten signature.
For help with the Medicare side, see our Medicare PECOS enrollment page.
Group practice extras
CMS lists the CMS-855B for clinics, group practices and certain other suppliers. It is separate from the CMS-855I for individual practitioners.
Anthem's New York page says facilities (health delivery organizations) may also need to be credentialed before joining the network.
Opening a new practice? The practice-launch sequence lives on our new practices page.
Dentists: what the ADA adds
The ADA's credentialing checklist for dentists (version dated 07.06.23) lists, under "You May Also Need," items including a digital copy of a DEA license and a CDS license, a copy of an anesthesia license, hospital affiliation information, Medicare numbers, and BLS and ACLS certification information. It says additional information may be required depending on the state.
The ADA says dentists are asked to sign one or more Authorization, Attestation, and Release documents after attestation.
These items are for dentists. They are not a list for physicians or other providers. Dental practices can see our dental PPO credentialing page.
Keep your records current
What to keep current | Who says it |
|---|---|
NPPES data, within 30 days of a change (covered providers) | CMS FAQ; 45 CFR 162.410(a)(4) |
The email address on your DEA registration | DEA registration page: keep it "correct and active" |
CAQH attestation, every 120 days (180 in Illinois) | DataSpring |
Licenses and documents about to expire (dentists) | DataSpring's dental FAQ |
How long each step takes is covered in our post on credentialing timelines.
Common questions
Is there a single credentialing checklist?
No. These items come from the pages named beside each one. Payers and provider types differ, so check each payer's own list.
Do I need a DEA certificate to be credentialed?
It depends on the payer and on whether you hold one. Cigna's page lists a DEA certificate, "one needed for each practicing state". The ADA's checklist for dentists lists it under "You May Also Need". Check the payer's own page.
When do I re-attest my CAQH profile?
DataSpring says every 120 days, or every 180 days for Illinois providers.
What should I not send through a website form?
Please don't send your Social Security number, DEA registration, license documents, or other sensitive documents through our web forms or by email.
Sources: CMS, Unique Identifiers FAQs (last modified 03/16/2026); eCFR, 45 CFR 162.410; CMS, Medicare Enrollment Applications (last modified 03/04/2026); Cigna Healthcare, Health Care Provider Credentialing; Anthem, Join Our Network (New York provider page); Blue Cross and Blue Shield of Montana, Completing The Application Process; Blue Cross and Blue Shield of Texas, Credentialing Process for Office Based Physicians or Professional Providers; DEA Diversion Control Division, Registration; DataSpring, Privacy Policy (effective September 29, 2026); DataSpring, Resources; DataSpring, CAQH Provider Data dental FAQs; ADA, Your Credentialing Checklist (version dated 07.06.23); ADA, ADA Credentialing Service; Aetna, Join the Aetna Network.