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National Provider Identifier (NPI)
NPI Provider Registration
Participating Provider Registration Forms
Participating providers can register their NPI(s) with Independence Blue Cross (IBC) by selecting the appropriate NPI registration form below, completing the form, and submitting it along with a copy of the provider’s NPI confirmation per the instructions provided at the bottom of the form.
| Participating Provider NPI Registration Form Type |
Link to Appropriate Registration Form |
| Professional Providers (e.g., PCPs, specialists) |
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| Facility/Ancillary Providers (e.g., hospitals, rehabs, DME, ambulance) |
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Nonparticipating Provider Registration Forms
Nonparticipating providers can register their NPI(s) with IBC by selecting the appropriate NPI registration form below, completing the form, and submitting it along with copies of the provider’s NPI confirmation and a completed W-9 form per the instructions provided at the bottom of the form.
| Nonparticipating Provider NPI Registration Form Type |
Link to Appropriate Registration Form |
| Professional Providers (e.g., PCPs, specialists) |
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| Facility/Ancillary Providers (e.g., hospitals, rehabs, DME, ambulance) |
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| Nonmedical/Atypical Providers (e.g., nonmedical transportation) |
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