New User Registration     *Required       * E-Mail :   We recommend using your email address  with out the domain name,i.e user@yourdomain.com  would be user.The user name field will automatically be populated with the first part of your email address,but may be changed at any time.   * User Name :   * Password :   * Confirm Password :      First Name :   * Last Name :      Title :      Department :   * Phone Number :      Fax :   * User Type : Provider Vendor Facility   * Company(s) Available Company(s)     ASSOCIATES MD MEDICAL GROUP INC AMDMG   CENTRUM MEDICAL HOLDINGS, LLC CENTRUM   PHYSICIANS PLUS – ARARAT MSO DCEARA   NEUEHEALTH ADVANTAGE ACO – BABYLON MEDICAL GROUP DCEBMG   PHYSICIANS PLUS - CLINICAS DEL CAMINO REAL DCECDCR   NEUEHEALTH PREMIER ACO – CENTRIC HEALTH DCECEN   NEUEHEALTH PREMIER ACO - PREMIER MEDICAL ASSOC DCECF   NEUEHEALTH COMMUNITY ACO - FQHC DCEFQHC   NEUEHEALTH ACO DCEMDP   NEUEHEALTH ADVANTAGE ACO – MEDICAL HOME NETWORK DCEMHN   NEUEHEALTH PARTNERS ACO - MEDICAL HOME NETWORK DCEMHNF   NEUEHEALTH PREMIER ACO - PALM FLORIDA DCEPFL   NEUEHEALTH COMMUNITY ACO - PALM TEXAS DCEPTX   NEUEHEALTH ADVANTAGE ACO - SOUTH CAROLINA DCESC   NEUEHEALTH ADVANTAGE ACO - ASSOCIATES MD MED GRP DCESF   NEUEHEALTH PARTNERS ACO - UNITED HEALTH CENTERS DCEUHC   NEUEHEALTH COLLABORATIVE CARE ACO MSSPCOL   UNITED PHYSICIANS NETWORK UPN Selected Company(s)     * Company(s) : --Select Company-- ASSOCIATES MD MEDICAL GROUP INC CENTRUM MEDICAL HOLDINGS, LLC PHYSICIANS PLUS – ARARAT MSO NEUEHEALTH ADVANTAGE ACO – BABYLON MEDICAL GROUP PHYSICIANS PLUS - CLINICAS DEL CAMINO REAL NEUEHEALTH PREMIER ACO – CENTRIC HEALTH NEUEHEALTH PREMIER ACO - PREMIER MEDICAL ASSOC NEUEHEALTH COMMUNITY ACO - FQHC NEUEHEALTH ACO NEUEHEALTH ADVANTAGE ACO – MEDICAL HOME NETWORK NEUEHEALTH PARTNERS ACO - MEDICAL HOME NETWORK NEUEHEALTH PREMIER ACO - PALM FLORIDA NEUEHEALTH COMMUNITY ACO - PALM TEXAS NEUEHEALTH ADVANTAGE ACO - SOUTH CAROLINA NEUEHEALTH ADVANTAGE ACO - ASSOCIATES MD MED GRP NEUEHEALTH PARTNERS ACO - UNITED HEALTH CENTERS NEUEHEALTH COLLABORATIVE CARE ACO UNITED PHYSICIANS NETWORK Add Delete   * Provider(s) Provider NPI: Provider Tax ID: Last Name: First Name: Search Clear Provider Name Provider ID Company ID   Provider Name Provider ID Company ID     * Vendor(s) Vendor ID: Vendor Name: Vendor Name Vendor ID Company ID Vendor Name Vendor ID Company ID   * Facility(s) Facility ID: Facility Name: Facility Name Facility ID Company ID   Facility Name Facility ID Company ID             Type the letters you see in the below picture BotDetect CAPTCHA ASP.NET Form Validation   Submit Request Clear Form

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