Physician credentialing checklist in 2025-26
Credentialing new physicians requires a comprehensive set of documents to verify their qualifications, professional history, and compliance with regulatory standards. Below is a detailed list of credentialing documents typically needed for new physicians, compiled from multiple authoritative sources:
Personal Information
Full name, contact information (email, phone, address)
Recent photograph signed and dated in the margin
Social Security card
Driver’s license or passport
Military discharge record – Form DD-214 (if applicable)
Immigration status documentation (Green Card, visa, or Permanent Resident Card for non-US citizens)
Professional Identification Numbers
National Provider Identifier (NPI) documentation and confirmation letter
Medicaid number
Medicare number
UPON number (if applicable)
Federal Tax ID number
Educational and Training Credentials
Medical school diploma and transcripts
Internship, residency, and fellowship certificates
Copy of NBME, FLEX, USMLE, or SPEX scores
ECFMG certificate number and Fifth Pathway information (for foreign medical graduates)
Licenses and Certifications
Current active state medical license wallet card(s) and wall certificate with expiration date and number
Current DEA certificate and State Controlled Substance Registrations or certificates
Board certification documents including issuing board name and dates of certification/recertification
ACLS, BLS, ATLS, PALS, APLS, NRP certificates (as applicable)
Mammo numbers and MQSA certification (if applicable)
Professional Experience and History
Current Curriculum Vitae with complete professional history in chronological order, including month and year, with no gaps
Work history including all practice locations and employment affiliations
Completed Delineation of Privileges Form
Completed Locum Tenens Practice Experience Form (if applicable)
Case logs from the last 24 months (if applicable)
Surgical logs (if applicable)
Current hospital and facility affiliations
Malpractice and Insurance
Malpractice claims history with detailed explanations
Certificate of professional liability insurance coverage or declaration page (face sheet) of policy (if applicable)
Third-party documentation for all malpractice or disciplinary actions (e.g., court documents, dismissals) or completion of an explanation form
Continuing Education and Professional Competence
- Current Continuing Medical Education (CME) activity for the past three years
- Three written letters of recommendation from providers who have directly observed the candidate in practice within the past year, assessing clinical competence and specifying dates observed
Health and Immunization Records
Copies of current immunization records and most recent TB test results (if available)
Personal health history (may be requested)
Conclusion
This comprehensive documentation ensures verification of education, licensure, clinical competence, legal standing, and professional history, which are critical for credentialing boards, hospitals, insurance companies, and healthcare organizations to approve a physician for practice and billing purposes
By preparing these documents thoroughly, new physicians can minimize delays and facilitate a smoother credentialing process.
