Provider DMAP Revalidation Lookup

Instructions:

  • Type in your NPI below. A "Revalidation required" note will immediately pop up if that NPI requires revalidation. If nothing appears, no revalidation is required. Note: You can only search one NPI at a time.
  • If revalidation is required, instructions will appear below.


  • Please enter in contact information and click submit so our team can track who has received the required documents


  • No need to click submit at the bottom of the form if the NPI you entered is not populated or found. This means that revalidation is not required at this time.
  • For an example of the "Revalidation required" note, you can enter: 1234567891 as an example to see what would pop up if your NPI needs revalidating.


Thank you!

Please ensure there are no extra spaces at the end of the NPI

Select or enter value
Caret IconCaret symbol

Revalidation required

You will need to send in an application.


Please fill out and return the one of the documents below to providerDMAPApps@modahealth.com with the subject line “2025 Medicaid DMAP Revalidation” so we may properly expedite your emails/applications.


For individual practitioners or providers


  • Please fill out and return the document titled “OHA DMAP individual all documents combined” When returning the completed application please attach a PDF copy of your active licensure for the state your practice is located. (Ex. If your clinic primary address is in Boise, submit your Idaho license.)


For Clinics/Facilities only


Phone
Powered by Smartsheet Modern Logo On Light
Privacy Notice|Report Abuse