Medical Credentialing Documents: A Complete Checklist for Providers

Medical credentialing is the process healthcare organisations use to verify a provider’s qualifications, such as education, training, licenses, certifications, and work history, before allowing them to deliver patient care. 

This step makes sure that only qualified professionals can practice, protecting patient safety and a facility’s reputation.

Complete and accurate documentation is important for a smooth credentialing process. Missing or outdated documents can delay approvals, affect insurance enrollment, and limit a provider’s ability to treat patients. 

Keeping credentials current and organised helps providers avoid delays, maintain compliance, and access more career opportunities.

In this article, we present a clear and easy-to-follow physician credentialing checklist to help ensure credentialing goes smoothly, quickly, and successfully for medical professionals.

 Credentialing Documents Checklist for New Physicians

• Current Curriculum Vitae (CV) covering complete professional history in chronological order, with no gaps, and including month/year for each entry.
• Verification of work history, including all previous practice locations and employment affiliations.
• Three written letters of recommendation from providers who observed your clinical practice within the last year, stating competence and observation dates.
• Copies of all current active state medical licenses — both wallet cards and wall certificates — showing expiration date and license number.
• Federal DEA and state-controlled substance registrations or certificates.
• Board certification documents showing the issuing board’s name and the dates of both original certification and recertification.
• Medical school diploma, residency and fellowship certificates, internship documentation, and any training certificates.
• Copies of NBME, FLEX, USMLE, or SPEX examination scores.
• If a foreign medical graduate, a copy of your ECFMG certificate and Fifth Pathway details (if applicable).
• Proof of Permanent Resident Card, green card, or visa status for non-U.S. citizens.
• Government-issued driver’s license and Social Security card.
• Personal contact details such as phone, email, and mailing address.
• Recent signed and dated photograph (with date in the margin).
• Your National Provider Identifier (NPI) confirmation letter or documentation.
• Medicare and Medicaid numbers.
• UPIN (if applicable).
• Federal Tax ID number (TIN/EIN).
• Malpractice documentation — certificate of coverage or policy declaration page, plus claims history reports (10-year claims report if applicable).
• Case logs or surgical logs from the past 24 months (if applicable).
• Documentation of hospital privileges held.
• Completed Delineation of Privileges form.
• Locum Tenens Practice Experience form (if applicable).
• Third-party documentation for malpractice or disciplinary actions, including court records or dismissal notices, or an official explanation form.
• Advanced Life Support certifications — ACLS, BLS, ATLS, PALS, APLS, NRP, as applicable.
• Mammo numbers/MQSA credentials (if applicable).
• Record of Continuing Medical Education (CME) over the past three years.
• Copies of current immunisation records and latest TB test results.
• Residency diploma (separate from certificates above, if applicable).
• Military discharge record (Form DD-214, if applicable).

Keeping these documents valid, clear, and up to date helps avoid delays in the credentialing process and speeds up your approvals.

Credentialing Documents Required for Physician Assistants (PAs) and Advanced Practice Registered Nurses (APRNs)

Credentialing for Physician Assistants and Advanced Practice Registered Nurses closely resembles that of physicians, with a few specific distinctions. 

Credentialing is legally required when these practitioners provide direct patient care to ensure qualifications and compliance with regulatory standards.

Here is an overview of the important documents typically needed for credentialing:

• Personal contact details such as email, phone number, and mailing address
• Recent photograph signed and dated in the margin for identification purposes
• Medicaid and Medicare numbers
• National Provider Identifier (NPI) documentation and official confirmation letter
• Federal Tax Identification Number (TIN or EIN)
• Proof of immigration status for non-U.S. citizens, such as a Permanent Resident Card, a Green Card, or a valid visa
• Copies of current state licensure wallet cards and wall certificates showing license number and expiration dates
• Federal DEA registration and state-controlled substance certificates (if applicable)
• Diplomas from college or university and any training certificates
• Evidence of Continuing Medical Education (CME) activities for the past three years
• Completed Delineation of Privileges Form, specifying the scope of practice
• Locum Tenens Practice Experience Form, if applicable
• Work history covering all practice locations and employment affiliations
• Current Curriculum Vitae (CV) with a complete professional timeline, including months and years, with no gaps
• Case logs from the past 24 months, if relevant to the speciality or employer
• Immunisation records and recent TB test results
• Academic transcripts and diplomas
• Three professional letters of recommendation from colleagues or supervisors familiar with the provider’s clinical skills
• Government-issued identification, such as a driver’s license and a Social Security card
• Military discharge documentation (Form DD-214), if applicable
• Documentation of professional practice evaluations, such as Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE), where required.

For advanced practice providers, thorough credentialing—including healthcare license verification- is especially important to demonstrate qualifications and to maintain compliance with healthcare regulations and accreditation standards.

Why Complete and Accurate Credentialing Documents Matter?

Incomplete or incorrect credentialing documents can delay approvals, cause claim denials, and create compliance risks that may lead to penalties or loss of accreditation.

Staying organised and keeping all credentials up to date ensures faster processing, smoother recredentialing, and compliance with regulatory requirements—helping providers protect their careers, avoid financial setbacks, and maintain patient trust.

Why Use Credentialing Services

Handling the medical credentialing process on your own can be time‑consuming, detail‑heavy, and stressful, especially when juggling patient care and day‑to‑day responsibilities. 

Between gathering dozens of required documents, meeting strict deadlines, and staying on top of ever‑changing payer or state requirements, even small oversights can cause costly delays.

A professional credentialing service like Get Credentialing Done takes this burden off your shoulders. 

Their specialists understand the exact requirements for physicians, PAs, and APRNs, and know how to prepare, verify, and submit your applications without missing critical details. 

They track expiration dates for licenses and certifications, manage payer follow‑ups, and ensure your documentation is always complete and audit‑ready.

By partnering with experts, you can:

• Save Time – Avoid hours of paperwork and back‑and‑forth with payers and licensing boards.
• Reduce Errors – Prevent mistakes that cause delays, rejections, or claim denials.
• Stay Compliant – Meet all regulatory and payer requirements with up‑to‑date documentation.
• Get Faster Approvals – Accelerate onboarding so you can start seeing patients and billing sooner.
• Focus on Care – Spend more time with patients and less on administrative tasks.

For busy providers, trusting Get Credentialing Done isn’t just convenient, but it’s a smart investment in your career, your income, and your peace of mind.

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