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Change an NPI Number

KanCare Provider Enrollment and Changes: Providers must use the Kansas Modular Medicaid System (KMMS) Provider Enrollment Wizard to update their information for any or all of the Medicaid fee-for-service (FFS) and managed-care organization (MCOs) health plans.

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Ambetter or Medicare Change an NPI Number

Please use the form below to change your group's NPI number for Ambetter or Medicare members.

Before you fill out the form below, please download all required documents and fill them out completely. Once you have completed your documents, be sure to finish the form below and upload your documents.

Change NPI Number for: required *

Update Requested By:

Complete and sign your W9 and upload it here.
Complete and sign your Facility Credentialing Application and upload it here.
Complete and sign your Facility Roster and upload it here.
Complete and sign your CAQH Data Form and upload it here.
Complete and sign your Disclosure of Ownership Form and upload it here.