Personal Information
Please complete name, specialty, degree and please indicate whether you are a provider of office staff.
Please select a subject so that the appropriate staff member can contact you. Please use the Comments section for your inquiry—the more detailed the comments the
better RCIPA staff are able to assist you.
Name (required)
Practice Name
Title
Please select a title
AC---Doctor of Medicine/Acupuncture (AC)
ACNP---Acute Care Nurse Practitioner(ACNP)
ACSW---Accredited Clinical Social Worker (ACSW)
ANP---Nurse Practitioner (Adult Health)
APL---Associate in Applied Science (APL)
ARNP---Advanced Registered Nurse Practitioner (ARNP)
ASN---Associate in Nursing (ASN)
Au.D---Audiologist (AUD)
BA---Bachelor of Arts (BA)
BHS---Bachelor of Health Science (BHS)
BS---Bachelor of Science (BS)
BSN---Bachelor of Science in Nursing (BSN)
CFNP---Certified Family Nurse Practitioner (CFNP)
CISW---Clinical Independent Social Worker (CISW)
CMFT---Certified Marriage & Family Therapist (CMFT)
CNM---Certified Nurse Midwife (CNM)
CNP---Certified Nurse Practitioner (CNP)
CPNP---Certified Pediatric Nurse Practitioner (CPNP)
CRNA---Certified Registered Nurse Anesthetist (CRNA)
CRNP---Certified Registered Nurse Practitioner (CRNP)
D MIN---Doctor of Ministry (D MIN)
DA---Doctor of Audiology (DA)
DC---Doctor of Chiropractic (DC)
DD---Doctor of Divinity (DD)
DDS---Doctor of Dental Surgery (DDS)
DDS, MD---Dentist and MD
DMD---Doctor of Dental Medicine (DMD)
DNP---Doctor of Nursing Practice (DNP)
DNS---Doctor of Nursing Science (DNS)
DO---Doctor of Osteopathy (DO)
DPM---Doctor of Podiatric Medicine (DPM)
DPT---Doctor of Physical Therapy
DSN---Doctor of Science in Nursing (DSN)
EDD---Doctor of Education (EDD)
FNP---Family Nurse Practitioner (FNP)
GNP---Gerontological Nurse Practitioner(GNP)
JD---Juris Doctorate (JD)
LAC---Licensed Acupuncturist (LAC)
LCSW---Licensed Clinical Social Worker (LCSW)
LCSW-R---Licensed Clinical Social Worker (LCSW-R)
LISW---Licensed Independent Social Worker (LISW)
LMCC---License of Medical Council of Canada (LMCC)
LMFT---Licensed Marriage & Family Therapist (LMFT)
LMHC---Licensed Mental Health Counselor
LMLS---Licentiate of Medicine/Licentiate of Surgery (LMLS)
LMSW---Licensed Master Social Worker (LMSW)
LMT---Licensed Massage Therapist
LPC---Licensed Professional Counselor (LPC)
LPN---Licensed Practical Nurse (LPN)
LSW---Licensed Social Worker (LSW)
MA---Masters of Arts (MA)
MAH---Masters of Adult Health (MAH)
MB---Bachelor of Medicine (MB)
MBA---Masters of Business Administration (MBA)
MBBCH---Bachelor of Medicine/Bachelor of Surgery (MBBCH)
MBBS---Foreign - Bachelor or Medicine and Surgery (MBBS)
MC---Master in Counseling (MC)
MD---Doctor of Medicine (MD)
MD, DDS---MD and Dentist
MD, FACP---Medical Doctor w/ FACP
MDDO---Medical Doctor/Osteopathic Doctor (MDDO)
MDIV---Master of Divinity (MDIV)
MED---Masters of Education (MED)
MFT---Marriage & Family Therapist (MFT)
MHSA---Masters of Health Services Administration (MHSA)
MN---Masters of Nursing (MN)
MPA---Masters of Public Administration (MPA)
MPH---Masters of Public Health (MPH)
MS---Master of Science (MS)
MS AUD---Masters of Science in Audiology (MS AUD)
MS ED---Masters of Science in Education (MS ED)
MSD---Master of Science in Dentistry (MSD)
MSN---Master of Science in Nursing (MSN)
MSP---Masters in Speech Pathology (MSP)
MSPSY---Master of Science Psychology (MSPSY)
MSPT---Master of Science Physical Therapy (MSPT)
MSW---Master of Social Work (MSW)
MTS---Master of Theological Studies (MTS)
NA---Nurse Anesthetist (NA)
ND---Doctor of Naturopathy (ND)
NP---Nurse Practitioner (NP)
OBGYNNP---Nurse Practitioner (Ob-Gyn)
OCNP---Nurse Practitioner (Oncology)
OD---Doctor of Optometry (OD)
OT---Occupational Therapist (OT)
OTA---Occupational Therapy Assistant (OTA)
OTR---Occupational Therapist (OTR)
PA---Physician Assistant (PA)
PA-C---Physician Assistant (Certified)
PHARM---Pharmacist (PHARM)
PHARMD---Doctor of Pharmacy (PHARMD)
PhD---Doctor of Philosophy (PHD)
PM---Post-Masters (PM)
PMHNP---Psychiatric Mental Health Nurse Practitioner (PMHNP)
PNP---Pediatric Nurse Practitioner (PNP)
PsyD---Doctor of Psychology (PSYD)
PT---Physical Therapist (PT)
PTA---Physical Therapy Assistant (PTA)
RCT---Respiratory Care Therapist (RCT)
RD---Registered Dietician (RD)
RN---Registered Nurse (RN)
RN, CDE---Certified Diabetic Educator
RNFA---Registered Nurse First Assistant (RNFA)
RPA---Registered Physician Assistant (RPA)
RPAC-PT---Physician Assistant(Physical Therapy)
RPT---Rehabilitation Physical Therapist (RPT)
SLP---Speech-Language Pathologist
STM---Masters of Sacred Theology (STM)
SW---Social Worker (SW)
WHNP---Nurse Practitioner (Women's Health)
Position
Please select a position
Administrative Office Staff
Allied Health Professional
Billing Manager
Business Manager
Clinical Office Staff
Credentialing Coordinator
Dentist
Physician
Practice Manager
Provider Network Manager
RCIPA TPA Business Partner
Specialty
Please select a specialty
Acupuncturist
Addiction Medicine-Anesthesiology
Addiction Medicine-Family Medicine
Addiction Medicine-Internal Medicine
Addiction Medicine-Psychiatry & Neurology
Adolescent Medicine-Family Medicine
Adolescent Medicine-Internal Medicine
Adolescent Medicine-Pediatrics
Allergy & Immunology
Allergy & Immunology, Allergy
Anatomic Pathology & Clinical Pathology
Anesthesiology
Anesthesiology Critical Care Medicine
Audiologist
Blood Banking & Transfusion Medicine
Cardiovascular Disease
Certified Diabetes Educator
Certified Nurse Midwife
Chiropractor
Chiropractor, Neurology
Chiropractor, Nutrition
Chiropractor, Orthopedic
Chiropractor, Pediatric Chiropractor
Chiropractor, Sports Physician
Clinical & Laboratory Dermatological Immunology
Clinical Cytogenetic
Clinical Neuropsychologist
Clinical Pathology
Clinical Psychologist
Clinical Psychologist (Adult Development & Aging)
Clinical Psychologist (Child & Adolescent)
Clinical Psychologist (Family)
Clinical Psychologist (Health)
Clinical Psychologist (School)
Clinical Psychologist - Addiction (Substance Use Disorder)
Clinical Psychologist Mental Retardation & Developmental Disabilities
Colon & Rectal Surgery
Dentist Anesthesiologist
Dermatology
Dermatology / Dermatopathology
Dermatology / MOHS-Micrographic Surgery
Dermatology, Pediatric Dermatology
Diagnostic Ultrasound
Dietitian, Registered
Electrodiagnostic Medicine
Emergency Medicine
Emergency Medicine-Emergency Medical Services
Emergency Medicine-Pediatric Emergency Medicine
Endodontics
Enterostomal Therapy
Family Health-Nurse Practitioner
Family Medicine
Family Medicine-Geriatric Medicine
General Practice
General Practice Dentistry
Hematology Pathology
Hospice & Palliative Medicine-Anesthesiology
Hospice & Palliative Medicine-Emergency Medicine
Hospice & Palliative Medicine-Family Medicine
Hospice & Palliative Medicine-Internal Medicine
Hospice & Palliative Medicine-Obstetrics & Gynecology
Hospice & Palliative Medicine-Pediatrics
Hospice & Palliative Medicine-Physical Medicine & Rehab
Hospice & Palliative Medicine-Psychiatry & Neurology
Hospice & Palliative Medicine-Radiology
Hospice & Palliative Medicine-Surgery
Hospitalist
Internal Medicine
Internal Medicine, Bariatric Medicine
Internal Medicine, Clinical Cardiac Electrophysiology
Internal Medicine, Critical Care Medicine
Internal Medicine, Endocrinology, Diabetes & Metabolism
Internal Medicine, Gastroenterology
Internal Medicine, Geriatric Medicine
Internal Medicine, Hematology
Internal Medicine, Hematology & Oncology
Internal Medicine, Hepatology
Internal Medicine, Infectious Disease
Internal Medicine, Interventional Cardiology
Internal Medicine, Medical Oncology
Internal Medicine, Nephrology
Internal Medicine, Pulmonary Disease
Internal Medicine, Rheumatology
Internal Medicine, Transplant Hepatology
Licensed Marriage & Family Therapist
Licensed Massage Therapist
Licensed Mental Health Counselor
Licensed Social Worker
Medical Genetics (MD)
Neurological Surgery
Neurology with Special Qualifications in Child Neurology
Neuromusculoskeletal Medicine & OMM
Nuclear Cardiology
Nuclear Medicine
Nuclear Radiology
Nutritionist
Obstetrics & Gynecology
Obstetrics & Gynecology, Critical Care Medicine
Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery
Obstetrics & Gynecology, Gynecologic Oncology
Obstetrics & Gynecology, Gynecology
Obstetrics & Gynecology, Maternal & Fetal Medicine
Obstetrics & Gynecology, Obstetrics
Obstetrics & Gynecology, Reproductive Endocrinology
Occupational Therapist
Occupational Therapist, Hand
Occupational Therapist, Pediatrics
Ophthalmology
Optometrist
Optometrist, Corneal and Contact Management
Optometrist, Low Vision Rehabilitation
Optometrist, Occupational Vision
Oral and Maxillofacial Pathology
Oral and Maxillofacial Radiology
Oral and Maxillofacial Surgery
Orthodontics and Dentofacial Orthopedics
Orthopaedic Surgery
Orthopaedic Surgery, Adult Reconstructive Surgery
Orthopaedic Surgery, Foot and Ankle Surgery
Orthopaedic Surgery, Hand Surgery
Orthopaedic Surgery, Orthopaedic Surgery of the Spine
Orthopaedic Surgery, Orthopaedic Trauma
Otolaryngology
Otolaryngology, Facial Plastic Surgery
Otolaryngology, Otolaryngic Allergy
Otolaryngology, Otology & Neurotology
Otolaryngology, Plastic Surgery within the Head & Neck
Pain Medicine, Interventional Pain Medicine
Pain Medicine-Anesthesiology
Pain Medicine-Pain Medicine
Pain Medicine-Physical Medicine & Rehabilitation
Pain Medicine-Psychiatry & Neurology
Pediatric Allergy & Immunology
Pediatric Anesthesiology
Pediatric Cardiology
Pediatric Critical Care Medicine
Pediatric Dentistry
Pediatric Emergency Medicine
Pediatric Endocrinology
Pediatric Gastroenterology
Pediatric Hematology-Oncology
Pediatric Infectious Diseases
Pediatric Nephrology
Pediatric Orthopaedic Surgery
Pediatric Otolaryngology
Pediatric Pathology
Pediatric Pulmonology
Pediatric Radiology
Pediatric Rheumatology
Pediatric Surgery
Pediatric Transplant Hepatology
Pediatric Urology
Pediatrics
Pediatrics Child Abuse Pediatrics
Pediatrics Clinical & Laboratory Immunology
Pediatrics Developmental & Behavioral Pediatrics
Pediatrics Medical Toxicology
Pediatrics Neonatal-Perinatal Medicine
Pediatrics Neurodevelopmental Disabilities
Periodontics
Physical Medicine & Rehab, Spinal Cord Injury Medicine
Physical Medicine & Rehabilitation
Physical Therapist
Physical Therapist, Orthopedic
Physical Therapist, Pediatrics
Physical Therapist, Sports
Plastic Surgery
Plastic Surgery Surgery of the Hand
Plastic Surgery Within the Head and Neck
Podiatrist
Podiatrist-Foot and Ankle Surgery
Podiatrist-Foot Surgery
Podiatrist-Primary Podiatric Medicine
Podiatrist-Sports Medicine
Preventive Medicine Medical Toxicology
Preventive Medicine Occupational Medicine
Preventive Medicine-Public Health & General Preventive Medicine
Preventive Medicine/Occupational Environmental Medicine
Prosthodontics
Psychiatry & Neurology, Clinical Neurophysiology
Psychiatry & Neurology, Neurology
Psychiatry & Neurology, Psychiatry
Psychiatry & Neurology, Psychosomatic Medicine
Psychiatry & Neurology, Vascular Neurology
Psychiatry Addiction Psychiatry
Psychiatry Child & Adolescent
Psychiatry Forensic Psychiatry
Psychiatry Geriatric Psychiatry
Psychiatry-Nurse Practitioner
Psychoanalyst
Radiation Oncology
Radiology, Body Imaging
Radiology, Diagnostic Radiology
Radiology, Neuroradiology
Radiology, Vascular & Interventional Radiology
Respiratory Therapist, Registered
Sleep Medicine-Family Medicine
Sleep Medicine-Internal Medicine
Sleep Medicine-Otolaryngology
Sleep Medicine-Pediatrics
Sleep Medicine-Psychiatry & Neurology
Speech-Language Pathologist
Sports Medicine-Emergency Medicine
Sports Medicine-Family Medicine
Sports Medicine-Internal Medicine
Sports Medicine-Orthopaedic Surgery
Sports Medicine-Pediatrics
Sports Medicine-Physical Medicine & Rehabilitation
Sports Medicine-Preventive Medicine
Sports Medicine-Psychiatry & Neurology
Surgery, General Surgery
Surgery, Plastic and Reconstructive Surgery
Surgery, Surgery of the Hand
Surgery, Surgical Critical Care
Surgery, Surgical Oncology
Surgery, Trauma Surgery
Surgery, Vascular Surgery
Therapeutic Radiology
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Transplant Surgery
Urology
Urology, Female Pelvic Medicine and Reconstructive Surgery
Subject(required)
Please select the subject of the contact
Aetna Fee Schedule Question
Aetna Provider Application Request
CAQH Question
General Aetna Question
General Independent Health Question
General RCIPA Inquiry
I want to become a RCIPA member
Independent Health Fee Schedule Question
New Mid-Level (NPPA) Joining Existing Practice
New Provider Joining an Existing Practice
Other-see Comments
Practice Change of Location
Practice Change of Tax Identification Number (TIN)
Question/Comment (required)