Want to modify your demographic information or add/remove a provider?
iCare makes it easy for providers to update this information.
Contracted providers wanting to modify their demographic or affiliation information can do this by filling out the applicable form below. Instructions are included on each form.
Name, Tax ID, Physical or Billing Address Changes:
Demographic Change Form - Print/Fax back
Demographic Change Form - Electronic
Adding or removing providers associated with a contracted provider group:
Affiliation Change Form - Print/Fax back
Affiliation Change Form - Electronic
NPPES is the National Plan and Provider Enumeration System. It provides core directory data elements (provider name, specialty, address, and telephone number) in a machine-readable format for virtually every provider in the country. Use of NPPES by providers improves provider directory reliability and accuracy.
Learn more about NPPES
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