Credentialing by state / Washington, DC
Nurse Practitioner Credentialing in Washington, DC
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
| NP practice environment | Full Practice (AANP) |
|---|---|
| Licensing authority | The Washington, DC board of nursing alone |
| Medicare contractor | Novitas Solutions, jurisdiction JL |
| Medicaid | DC Medicaid, enrolled through the DC Medicaid provider portal (Conduent) |
| Medicaid managed care | 5 plans, 238,159 members (2024) |
| Blue Cross Blue Shield plan | CareFirst BlueCross BlueShield |
Washington, DC Is a Full Practice State
The American Association of Nurse Practitioners classifies Washington, DC as full practice: state law lets nurse practitioners evaluate patients, diagnose, order and interpret tests, and prescribe under the exclusive licensure authority of the state board of nursing. 28 of the 50 states and DC have that classification.
For credentialing, full practice means the application is about you alone. DC Medicaid and the commercial plans in Washington, DC generally do not ask for a collaborating physician, so the fields that hold up NP files in other states are simply absent. Medicare's rule for NP services (42 CFR 410.75) defers to state law on collaboration, and where state law is silent it expects the NP to document their scope of practice and how they work with physicians on issues outside it. Enrollment itself runs through PECOS and Novitas Solutions on the CMS-855I like any other independent practitioner.
What still slows Washington, DC NPs down is the business side: an NP-owned entity needs its own Type 2 NPI, a group enrollment and a reassignment for each clinician, and some commercial plans review NP-owned practices more slowly than physician groups. If you are new to independent practice, confirm with the board whether any transition-to-practice hours apply to you before the applications go in, because payers will ask for the license status that results.
DC Medicaid Managed-Care Plans for NPs
After the state enrollment, each managed-care plan credentials you as its own application. The largest in Washington, DC by 2024 enrollment:
- AmeriHealth Caritas District of Columbia: 106,839 members, owned by Independence Health Group
- MedStar Family Choice District of Columbia: 56,860 members, owned by MedStar Health
- Amerigroup District of Columbia: 56,651 members, owned by Elevance Health
See all 5 plans.
Neighboring States
If you practice near the border or by telehealth, the rules change at the state line: Virginia is restricted practice. Maryland shares Washington, DC's classification.
- Maryland NP credentialing (Full Practice)
- Virginia NP credentialing (Restricted Practice)
The full NP checklist, the entity decision and where applications stall are in our nurse practitioner credentialing guide. For Medicare, Medicaid and commercial plans for every clinician type in the state, see credentialing in Washington, DC.
Questions Washington, DC NPs Ask
Do Washington, DC nurse practitioners need a collaborating physician to get credentialed?
No. AANP classifies Washington, DC as full practice, so payers generally do not require a collaborating physician on an NP application. Check with the board of nursing whether any transition-to-practice requirement applies to a newly licensed NP.
How does a Washington, DC NP join DC Medicaid?
Enroll with the DC Department of Health Care Finance through the DC Medicaid provider portal (Conduent). Most DC Medicaid members are in managed care (238,159 enrolled across 5 plans in 2024), so after the state enrollment is active, each plan you want, such as AmeriHealth Caritas District of Columbia, MedStar Family Choice District of Columbia, Amerigroup District of Columbia, credentials you separately.
Can an NP licensed in Washington, DC see patients in a neighboring state?
Only with a license from that state, and each state's practice rules apply to the patients there. Maryland is full practice; Virginia is restricted practice. Payer enrollment is also per state, so seeing patients across the line means a separate Medicaid enrollment and separate commercial applications there.
What does PECS charge a Washington, DC NP?
CAQH (DataSpring) profile build $500; Medicare enrollment $500; DC Medicaid enrollment $500; each commercial application, including CareFirst BlueCross BlueShield, $200 per provider. Enrollment services bill 50% at engagement and 50% at submission.
Answers cover PECS services, prices and process. For legal, tax or clinical questions please consult a professional.
Sources: American Association of Nurse Practitioners, State Practice Environment (updated May 2026); KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Practice classification is AANP's; confirm current rules with the Washington, DC board of nursing. Updated October 7, 2026.