CREDENTIALINGCURRENT

Follow the record. Separate the decisions. Keep the workforce ready.

Authority library

Authorities and standards record

Each record preserves the issuing authority, jurisdiction, instrument or authority type, legal or operating status, version and application dates, affected audience, workflow mapping, source link, and interpretation boundary.

United States Medicare program · U.S. federal provider-enrollment system

CMS PECOS

PECOS is CMS's online system for Medicare provider and supplier enrollment, revalidation, changes of information, reassignment, ownership and managing-control records, and related enrollment administration. It is not a credentialing or privileging system.

United States Medicare program · U.S. federal program manual

CMS MPIM Chapter 10

Chapter 10 documents Medicare provider and supplier enrollment processes, screening, application review, site visits, revalidation, ownership, revocation, deactivation, and contractor operations.

United States · U.S. federal identifier program

NPPES and NPI

NPPES enumerates healthcare providers and maintains NPI-associated public data. CMS explicitly states that NPI issuance does not ensure or validate licensure or credentialing and does not ensure Medicare enrollment.

United States Medicare fee-for-service · U.S. federal public dataset

CMS Medicare FFS Public Provider Enrollment data

The dataset publishes selected Medicare fee-for-service provider and supplier enrollment characteristics for public analysis, subject to its data dictionary, suppression, update cadence, and program scope.

United States hospitals participating in Medicare and Medicaid · U.S. federal regulation

CMS Hospital Governing Body Condition

The governing body is accountable for the hospital's conduct, appoints medical staff based on recommendations, and ensures criteria and procedures govern selection and appointment, subject to the full regulation.

United States hospitals participating in Medicare and Medicaid · U.S. federal regulation

CMS Hospital Medical Staff Condition

The condition addresses organized medical staff accountability, examination of credentials, recommendations on appointment, and periodic appraisal, within the complete regulatory and interpretive framework.

United States Medicaid programs and affected providers · U.S. federal regulation

Medicaid Provider Screening and Enrollment

The cited provisions address enrollment, screening, and federal database checks for Medicaid providers, with implementation details and provider categories varying across programs and states.

Organizations seeking applicable NCQA accreditation or certification · private accreditation and certification standards body

NCQA 2026 CR/PN Standards

NCQA's credentialing and provider network standards support defined accreditation and certification programs. Public summaries do not reproduce the licensed standards or establish an organization's current status.

Organizations and programs surveyed under applicable Joint Commission manuals · private healthcare accreditation organization

The Joint Commission PSV FAQ

The FAQ defines primary-source verification and explains that the accredited organization remains responsible for obtaining and verifying specified credentials under the applicable manual and setting.

United States organizations authorized to query the NPDB · U.S. federal program guidance

NPDB Delegated Credentialing Guide

The guide explains how eligible organizations may use authorized agents and delegated credentialing arrangements for NPDB querying while preserving eligibility, authorization, confidentiality, and organizational responsibility.

United States federal healthcare programs · U.S. federal exclusion program

OIG LEIE

OIG publishes exclusion information and monthly LEIE data. Name or identifier matching requires care, and the official program record and facts must be reviewed before an organization takes action.

Organizations seeking URAC CVO accreditation · private healthcare accreditation organization

URAC CVO Accreditation

URAC offers an accreditation program for credentials verification organizations. Current status, scope, effective period, and organization identity must be confirmed from URAC records.

Participating U.S. providers and healthcare organizations · industry provider-data utility

CAQH Provider Data Portal

The portal supports provider profiles, attestations, documents, and data exchange used by participating organizations in credentialing and enrollment workflows. DataSpring is the current organization name; the CAQH portal name remains visible in the market.

How to read the library

Binding requirements, official guidance, technical standards, implementation guides, program rules, and authority data are not interchangeable. Each page names the source class and states what it can and cannot establish about an organization or product.