Please fill out the information for Provider to participate in New York Network IPA.

  • Must be provider email for electronic signature

The following documentation will be emailed to you for electronic signatures to initiate the IPA credentialing process:

  • NYNM IPA Agreement
  • NYNM IPA Participation Acknowledgement
  • NYNM IPA Appendix Acknowledgement
  • HIPPAA Agreement

Please contact provider relations at for any questions.