Medicaid

How to Get Credentialed with New York Medicaid in New York

Network: Open
30-90 Days

Quick Overview

Timeline

30 - 90 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

New York-Specific Requirements

New York Medicaid Managed Care enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the DOH (Department of Health) eMedNY provider enrollment portal. (3) Submit application with NY state license, proof of malpractice insurance, and required documentation. (4) Background check including state and federal criminal history is required for all providers. New York operates mandatory managed care in most counties with multiple MCOs and Health and Recovery Plans (HARPs) for behavioral health. Behavioral health providers accepted include LMHC, LCSW, LMFT, and Licensed Psychologist with active New York licensure. Revalidation is required every 5 years.

Medicaid Information — New York

Agency: NYSDOH

Program: New York Medicaid

Portal: https://portal.emedny.org/provider

Phone: 1-800-343-9000

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for New York.

2

Prepare Your Application

Complete New York Medicaid's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to New York Medicaid.

4

Track & Follow Up

Credentialing typically takes 30-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Background Check

Federal/state background check required for Medicaid enrollment

CV/Resume

Work history required

DISCLOSURE_FORM

Compliance program per 18 NYCRR Part 521

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

New York Medicaid eMedNY Enrollment

Required
Online Open →

Contact Information

Provider Enrollment

National

1-800-343-9000

General Provider Inquiries

National

1-800-343-9000

Quick Links

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