Allied Health Providers

Start the Credentialing and Contracting Application Process

View, download and complete the specific credentialing application checklist and any additional forms and documents as outlined in the checklists below. Submit forms and documents by either emailing them to or by faxing them to 617.673.0909. To facilitate review of a provider's application, submit all materials together.

Note: All individually credentialed Allied Health providers must complete the CAQH application. Allied Health providers that are credentialed at the group or facility level do not need to fill out the CAQH application.


Ambulatory Surgical Center

Birthing Centers



Durable Medical Equipment (DME)

Family Planning

Home Health Agency

Hospice Agency

Imaging Facility

Inpatient and Outpatient Rehabilitation


Orthotics and Prosthetics

PT/OT/ST Provider Groups

Registered Dietitians

Sleep Centers

Skilled Nursing Facility