MavenMD

Apply to join MavenMD

Start with your NPI — we'll pull what we can from the registry. Full profile and availability come after credentialing.

Start with your NPI

NPI number

Legal first name

Legal last name

Credential

Primary specialty

State licenses

State

License number

DEA number (if you'll prescribe)

Account

Work email

Password

At least 12 characters

One uppercase letter

One lowercase letter

One number

One special character

Mobile phone

Practice

Solo practice

Part of a group

Consent

Backend needed

Placeholder legal text — the official CAQH Standard Authorization template replaces this once it's published to the attestation registry.

Attestation

I attest that the information provided in my credentialing application is current, complete, and accurate to the best of my knowledge.

Authorization

I authorize MavenMD and the payers, hospitals, and entities referenced in my application to verify my credentials.

Release

I release MavenMD and referenced entities from liability related to the good-faith verification of my credentials.

I agree to the Terms of Service

I acknowledge the HIPAA Business Associate Agreement terms

I have read the Standard Authorization, Attestation and Release, and authorize MavenMD to verify my licenses, credentials, and background as part of credentialing. Submitting this application is my signature.

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