To provide a smooth onboarding for all of our new providers, OAM has an onsite credentialing coordinator who is available to assist all of our new Independent Practitioners (MD, DO, PA, NP, OT, PT) with the application process to ensure the credentialing process as seamless as possible. The following items, as applicable by provider type, will be needed to begin the credentialing process.

• Full Contact Info – Name, Address, Phone, Cell, Email (including prior names)
• Date of Birth (City & State of Birth)
• Social Security Number
• CV / Resume – including education with dates attended in month/year
• Format and contact address/phone
• Work History – include dates in month/year format and contact address/phone
• Explanation of any employment gaps greater than 3 months
• Current/Previous Hospital affiliations including dates on staff, contact address/phone and approved privilege list
• Michigan Professional License and Controlled Substance License
• Documentation of All State Professional Licenses (past & present)
• DEA License
• Driver’s License
• Professional School Diploma
• Internship certificate of completion
• Residency certificate of completion
• Fellowship certificate of completion
• Documentation of procedure volumes for past 12 months (residency/fellowship logs)
• Board Certificate(s) or confirmation letter – explanation of intent
• Current and past malpractice insurance declaration pages (prior 10 years)
• Malpractice Claim History (prior 10 years) including a current NPDB
• Report (NPDB self query can be completed at http://www.npdb-hipdb.hrsa.gov)
• Current ACLS or BLS
• Immunization Record – including TB, Flu, HEP B, MMR, Varicella
• Three Peer References (name, address, phone, fax, email)
• NPI Number – NPI login & password
• CAQH ID Number – user name and password

The credentialing coordinator works to ensure the credentialing process moves along efficiently so patients have access to care from OAM’s top quality providers as soon as possible.