Physician Assistant (PA) Credentialing Checklist

PA degree from accredited program (transcripts) Required

Current state PA license (all states where practicing) Required

NCCPA certification (current PA-C) Required

Supervisory or collaborative agreement (if required by state) Optional

DEA certificate (current and valid) Required

NPI number confirmation Required

CAQH ProView profile (completed and attested) Required

Current malpractice insurance certificate (face sheet) Required

Prescriptive authority documentation (if applicable) Optional

CPR / BLS certification (current) Required

Professional references (minimum 3 peer references) Required

Curriculum vitae / resume (up to date, no gaps) Required

Government-issued photo ID (driver's license or passport) Required

Signed attestation questionnaire Required

W-9 form (completed and signed) Required