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Provider Maintenance


Updating Provider Demographic Information

Having access to accurate provider information is vitally important to SilverSummit members. To ensure a member’s health is not compromised, providers are required to have their contact and demographic information up-to-date. Providers should notify SilverSummit of any changes (ex. address or telephone number updates), if they can no longer accept new patients or are leaving the network.

For the requests listed below, please complete this PDQ Request Form:

  • Add Practitioner(s) to a Contracted group

            - requests must include a completed Practitioner Data Form(PDF)

            - If adding 30 or more individual practitioners, please reach out to      for a Blank Credentialing Roster

  • Removing Practitioner(s) from a Contracted group
  • Panel Updates
  • Other demographic updates that cannot be updated through the SilverSummit Provider Portal


**Please ensure the following information is complete to avoid any delays or returns:**

  • The Practitioner Data Form (PDF) is completed in its entirety
  • CAQH was Attested within the last 6 months and that SilverSummit has access.
  • Taxonomy Specialty included matches NPPES and License


All requests will be worked in the order they are received. An email notification will be sent confirming that your request has been received with a reference ID at the bottom of the email. An email notification will also be sent once a ticket has been submitted and once the request has been completed.


For faster service, providers can update the following information through the SilverSummit Provider Portal:

  •  Phone number updates
  •  Location updates


Additional Resources

*If you are inquiring about claims issues or projects, please access the Provider Claims Tools or reach out to your Provider Relations Representative. 

You can send an  email to

*For Provider Demographic related inquiries not outlined above please send an email to