Moving your practice

Moving Your Practice to New York: Credentialing Checklist

A move to New York touches every enrollment you have. The license, NPI record, Medicare enrollment, New York Medicaid, each commercial plan, your CAQH (DataSpring) profile, your DEA registration and your malpractice policy all have to show New York before claims there pay. Here is the order that works, with the New York specifics.

The Checklist, Step by Step

1. Get the New York license. Physicians apply to the New York State Education Department, Office of the Professions (State Board for Medicine). Nurses and nurse practitioners apply to the New York State Education Department, Office of the Professions (State Board for Nursing). Every later step needs the license number, so start here.
2. Register with DEA for New York. DEA registrations are state-specific: you need a registration in each state where you handle controlled substances, and the state license comes first. If you are leaving your old state, change the address on your current registration to New York; if you will practice in both states, get a separate New York registration.
3. Cover New York on your malpractice policy. Many policies are written for specific states. Ask your carrier to add New York or write a new policy before your first patient there, and settle tail or prior-acts coverage if you are leaving your current carrier.
4. Add the New York location to your NPI record. Your NPI does not change. Log in to NPPES and add the New York practice location within 30 days of the change. If you still practice in your old state, keep that location too; an NPI record can list more than one practice location. Payers check applications against this record, so update it before you apply.
5. Update and re-attest your CAQH (DataSpring) profile. Add the New York practice location, the New York license, the new DEA registration and the malpractice certificate that covers New York, then re-attest. Every commercial plan reads this profile, so do it before any commercial application goes out.
6. Update Medicare in PECOS. Medicare in New York is handled by National Government Services, jurisdiction JK. If your current enrollment is with a different contractor, file a new CMS-855I with National Government Services; the 855I covers only practice locations inside one contractor's jurisdiction. If National Government Services already has your enrollment, add the New York location to it. If you will bill through a group, file the reassignment to that group at the same time. The effective date is the later of the filing date or the date you began seeing patients at the new location (42 CFR 424.520(d)), and you can bill up to 30 days before it when circumstances kept you from enrolling earlier (42 CFR 424.521(a)). File as soon as you have the license and the address.
7. Enroll in New York Medicaid. New York Medicaid is run by the New York State Department of Health, and enrollment is filed through eMedNY. Medicaid enrollment does not transfer between states, so a new state means a new enrollment. Most New York Medicaid members are in managed care plans, and each plan credentials you separately once the state enrollment is active. Step by step: eMedNY Provider Enrollment: New York Medicaid Step by Step. The plans and how to join each one: New York Medicaid managed care plans.
8. Get credentialed with Anthem Blue Cross and Blue Shield and the other commercial plans. Blue plans in New York: Anthem Blue Cross Blue Shield (formerly Empire), Excellus BlueCross BlueShield and Highmark Blue Cross Blue Shield of Western New York. Blue plans are separate companies licensed state by state, so a Blue contract in your old state does not cover New York; apply as a new provider. National plans such as Aetna, Cigna, UnitedHealthcare and Humana need the New York location added and credentialed before they pay claims there. New York law gives commercial plans 60 days to make a credentialing decision, counted from a completed application (N.Y. Ins. Law § 4803(a); N.Y. Pub. Health Law § 4406-d). How to join: Anthem Blue Cross and Blue Shield; Excellus BlueCross BlueShield; Highmark Blue Cross Blue Shield.

While you wait in New York: A newly licensed or newly relocated professional joining a group whose members all participate is provisionally credentialed from day 61 if no decision is made.

What PECS Charges for a Move to New York

Example: one provider moving to New York with Medicare, New York Medicaid, the CAQH update, the NPI update and 3 commercial plans is $1,950. We follow up with every payer until each application is approved, and you can check status any time with your reference number.

Questions About Moving to New York

Sources

• New York State Education Department, Office of the Professions (State Board for Medicine)
• CMS-855I Medicare enrollment application (practice locations in another MAC jurisdiction need a separate 855I)
• 42 CFR 424.520(d): effective date of billing privileges
• 42 CFR 424.521(a): billing up to 30 days before the effective date
• 45 CFR 162.410(a)(4): report NPI data changes within 30 days
• DEA Diversion Control: registration FAQ (separate registration in each state)
• Interstate Medical Licensure Compact member list (CSG)
• Nurse Licensure Compact (NCSBN)
• PSYPACT map
• Counseling Compact map

By the PECS credentialing team, updated October 20, 2026. Compact memberships and board names checked in October 2026; confirm with the board before you apply.