Credentialing
CAQH Credentialing and NPI Registration for Providers
CAQH credentialing runs on one profile that 1,000 health plans, hospitals and other organizations draw on, by DataSpring's count: the CAQH Provider Data Portal, now run by DataSpring, powered by CAQH. We set it up, calendar every re-attestation and keep each provider's NPI record in line with it. Re-attestation is due every 120 days, and the profile turns Expired the day after a missed date.
The short answer
How does CAQH credentialing work?
Health plans draw on one profile in the CAQH Provider Data Portal, now run by DataSpring. Register, complete every section, authorize the plans, attest and upload your documents; then re-attest every 120 days, because Cigna uses only profiles in Initial Profile Complete or Re-attestation status. The Advixor Group sets up and maintains each provider's profile, calendars every re-attestation and registers and maintains NPIs in NPPES.
SourcesDataSpring Provider User Guide v46.0DataSpring rebrand noticeCigna credentialing
One profile
What is CAQH?
The CAQH Provider Data Portal, formerly CAQH ProView, is one online profile of your professional and practice information. You enter it once, attest that it is accurate, upload the documents behind it and choose which organizations may read it. The profile is free for providers, and so is the NPI (what credentialing costs). DataSpring also counts 2.5 million participating providers.
The profile is not an application to any plan. UnitedHealthcare still needs your request for participation when you already have a CAQH ID and have authorized it; the plan then verifies what the profile says, and that verification is credentialing. Your rates come later, in the contract.
Health plans
Which plans use CAQH for credentialing
- Florida Blue makes CAQH its preferred source of application data and wants the profile currently attested.
- Humana requires CAQH participation.
- Aetna uses it for credentialing and recredentialing; you authorize Aetna to review it.
- Cigna pulls an existing profile electronically, with your permission.
- UnitedHealthcare uses it in most states; a few use a state-mandated portal instead.
- Optum Behavioral Health requires it in most states and checks that your participation form matches it.
- Evernorth Behavioral Health asks individual clinicians for their CAQH ID.
Registration
CAQH registration, step by step
These are DataSpring’s steps, in its order. The first profile takes up to two hours, longer with several practice locations, long training or a long work history.
Uploads fail when they are illegible, not compliant (missing a date or signature, or two documents in one file) or ineligible (expired, or filed under the wrong type, such as a license uploaded as liability insurance). Florida Blue’s September 2026 manual still says to fax documents to CAQH; DataSpring’s guide says faxing isn’t supported, so upload them.
| Step | What you do | Rule or timing |
|---|---|---|
| 1. Register | “Register here” at proview.caqh.org: NUCC grouping, provider type, name, address, primary practice state, birthdate, email, SSN, NPI, DEA, license state and number (tick a box for any you don’t have yet) | Your CAQH Provider ID comes by email |
| 2. Complete the profile | Every section, gap records included | Gaps to explain: chart below |
| 3. Review | Clear the required fixes and read the suggested ones | DataSpring checks that the DEA, NPI and TIN match your name |
| 4. Authorize | Global (any organization that rosters you; DataSpring recommends it) or one organization at a time | No plan sees the profile until you do |
| 5. Attest | Confirm that everything is accurate | Starts the 120-day clock |
| 6. Upload documents | PDF, TIF, JPG or JPEG, one document per file, plus the signed Authorization, Attestation and Release (AAR) form | Within 120 days of each signature; reviewed in about 48 hours |
Source DataSpring, Provider User Guide v46.0 (June 15, 2026), sections 1.1, 2.2.1, 5.1, 6, 7 and 8.1, and Appendix A.
Work history
Gaps in your CAQH application: how much each form makes you explain
The profile builds a gap record for each break in your history. How long a gap can go unexplained depends on the application.
A provider licensed in several states saves a second pass by writing every explanation to the strictest rule that applies.
Sources DataSpring Provider User Guide v46.0, section 4.10.2; Florida Blue Provider Manual (Sep 24, 2026), p. 11.
Staying current
CAQH attestation: the 120-day cycle
Completing the attestation steps in the quarterly directory-confirmation email re-attests the profile every 90 days.
Statuses tell you where a profile stands: Profile Data Submitted (attested, documents pending), Initial Profile Complete (documents approved), Re-Attestation (every attestation after the first) and Expired Attestation.
- 15, 10 and 5 days beforeDataSpring emails a reminder.
- The due date120 days after your last attestation, or 180 in Illinois.
- The day afterExpired notices begin, then follow at 14, 28 and 42 days; the last is final.
Source DataSpring, Provider User Guide v46.0, Appendix A.
Your NPI
NPI registration: Type 1, Type 2 and taxonomy codes
The NPI is the 10-digit identifier that HIPAA requires on standard transactions. NPPES, run by CMS, assigns it, and Medicare, Medicaid and private plans all use it.
- Type 1 is for individuals, physicians, nurse practitioners and sole proprietors among them: one per person, and it stays the same when your name, address or taxonomy changes.
- Type 2 is for organizations such as physician groups, hospitals and nursing homes, which can hold several, so a group you are starting applies as an organization. An incorporated provider can hold both, a Type 1 for themselves and a Type 2 for the corporation or LLC.
- Three ways to apply for NPI number registration: online in NPPES, on the paper form, or through an employer that files for you in bulk (Electronic File Interchange).
- Taxonomy codes are 10 characters and describe your classification and specialization. You can choose several, with one marked primary, and the code set is published every January and July. Codes for therapists: mental health credentialing.
An NPI doesn’t license, credential or enroll you, and doesn’t guarantee payment. Medicare requires one for enrollment, but updating NPPES doesn’t update your Medicare enrollment. In a February 10, 2026 alert to behavior analysis providers (provider type 39), AHCA warned that a missing or outdated NPI on the Florida Medicaid provider file will keep an existing account from merging into its new enrollment system: Florida Medicaid enrollment.
“A covered entity that is a covered health care provider must: … (4) Communicate to the NPS any changes in its required data elements in the NPS within 30 days of the change.”
Our service
What we do in your CAQH profile, and what only the provider can do
Only the provider can authorize organizations to see the profile, and only the provider signs the AAR, by hand or electronically. Hiring a provider? Ask for the CAQH ID and NPI with the offer, so the profile carries your locations and authorizations before the first day: healthcare recruiting.
Have each provider’s CAQH ID, if there is one, and NPI at hand when you contact us.
CAQH credentialing
- Each provider’s profile in the CAQH Provider Data Portal set up and maintained, or an existing one cleaned up
- The documents plans ask for: licenses, DEA registration, malpractice coverage, work history and board certification
- NPIs registered and maintained in NPPES
What’s included
What our CAQH credentialing service includes
Payer enrollment
Use the finished profile to apply to each plan through its own door.
Learn moreRecredentialing
Keep every re-attestation, recredentialing, revalidation and renewal date on one calendar.
Learn moreMedicare enrollment
Enroll in Medicare with the CMS-855I and keep that record in step with NPPES.
Learn moreFlorida Medicaid enrollment
Enroll each provider with Florida Medicaid, then join the plans that serve Miami-Dade (Region I).
Learn moreNP and PA credentialing
How NPs and PAs set up CAQH and NPI records and get credentialed.
Learn moreMental health credentialing
How LCSWs, LMHCs and LMFTs get credentialed, with taxonomy codes and networks of their own.
Learn moreQuick answers
CAQH credentialing and NPI: questions from providers and office staff
Your CAQH ID, the DataSpring name change, NPs, NPI lookups and what office staff can enter. For anything else, book a consultation.
How do I find my CAQH number?
CAQH is now DataSpring. Do I need a new account?
Do nurse practitioners need a CAQH profile?
How do I look up an NPI number?
Can office staff fill in a provider's CAQH profile?
Talk to an advisor
You care for patients. Who’s taking care of the business?
Tell us where your practice is today. We will tell you what we would do first.
Official sources
- DataSpring, Provider User Guide v46.0 (June 15, 2026), resources and FAQs, Clinician Q&A (June 2026) and rebrand notice (June 7, 2026), read Oct 17–19, 2026
- CAQH Provider Data Portal, sign-in page, read Oct 19, 2026
- CMS, NPI Fact Sheet (Dec 2024), NPI: What You Need to Know (ICN 902603, Aug 2014) and Find your taxonomy code (Jul 29, 2025), read Oct 19, 2026
- NPI final rule, 69 FR 3434, Jan 23, 2004 (no fee to be assigned an NPI or to update NPS data, p. 3449), and 45 CFR 162.410, eCFR, read Oct 19, 2026
- UnitedHealthcare, Credentialing and recredentialing FAQ (Oct 14, 2026), read Oct 19, 2026
- Cigna, Health care provider credentialing; Aetna, network FAQs; Optum, Individually credentialed clinicians; Evernorth, Join the behavioral network; read Oct 19, 2026
- Florida Blue, Provider Manual: Provider Participation (Sep 24, 2026), p. 11, read Oct 19, 2026
- Humana, Credentialing and Recredentialing Policy, read Oct 17, 2026
- AHCA, Florida Medicaid alert to behavior analysis providers (Feb 10, 2026), read Oct 19, 2026, and Provider Enrollment Policy (Feb 2026), read Oct 17, 2026
- How we choose and date sources: editorial policy