Integrative Wellness

Pharmacy Services

Behavioral Health

Dental

Search HIPusa.com

Powered by

Login

Register | Forgot your password?

Provider Options

Search Providers
Provider Manual
Find a Bariatric Center of Excellence
Find an Urgent Care Center
Find a MinuteClinic
View Provider Materials
View Dental Program
HIP Connected Electronic Technology Depot
Provider IVR Phone System
HIP/Prism Chiropractic Program
HIP/Cogent Hospitalist Program
Contact HIP Provider Customer Service
Medical Guidelines
Provider Credentialing Tool: CAQH Universal Credentialing Datasource

questdiagnostics.com

Behavioral Health Options for Providers

NPI Collection Form

for Professional Providers

		* = Required fields

	* NPI	* Group Individual
	* Last Name	For Individual NPI submission only.
	* First Name	For Individual NPI submission only.
	* Group Name	For Group NPI submission only.
	License No
	* Contact Name
	* Contact Phone	- -