AHCCCS Provider Registration Packets

The Provider Registration process is required for those who provide medical care services (including primary care doctors, transportation, etc) to AHCCCS beneficiaries.

Provider Registration Requirements for Licensed Naturopathic Physician

The Arizona Health Care Cost Containment System (AHCCCS) is accepting applications from licensed Naturopathic Physicians who wish to serve AHCCCS members under Early Periodic Screening Diagnostic and Treatment (EPSDT). This AHCCCS provider type is active and is designated as 17-Naturopath in the AHCCCS Provider Registration system.

In order to submit claims for AHCCCS Fee for Service Programs, an active AHCCCS provider registration is required. In order to submit claims for AHCCCS managed care organizations (MCOs), Naturopathic physicians will need to be credentialed and contracted with the MCO(s) in addition to having an active AHCCCS provider registration.

Provider Registration forms are provided in two types of packets:

AHCCCS Provider Address Updates

The Provider Address Update Form is for existing providers to add or change addresses and tax identification numbers on their provider file at AHCCCS.

Click on the appropriate links below:

NOTE: Registered AHCCCS Providers may change their correspondence address using the AHCCCS online Provider Website.

The Out of State/One-time Waiver of Registration Requirements applies to those out of state providers that offer covered services to AHCCCS members. Certain restrictions apply; see One-time Waiver Requirements and Excluded Cities List below.

Providers, who are excluded from this policy, may register using the standard provider registration process.

Mail or fax completed and signed registration forms.

  • Mail:
    AHCCCS Provider Registration
    P.O. Box 25520, Mail Drop 8100
    Phoenix, AZ 85002
  • Fax:
    Attn: AHCCCS Provider Registration
    602 256-1474

Note: All applicable licenses and certifications must be submitted with the registration forms. If you have questions regarding the types of applicable licenses or certifications, please contact Provider Registration at the phone numbers listed below.

For questions regarding the provider registration process, please contact the AHCCCS Provider Registration Unit.

  • Call:
    • In Maricopa County: 602-417-7670 and select option 5
    • Outside Maricopa County: 1-800-794-6862
    • Out-of-State: 1-800-523-0231
  • Write:
    Arizona Health Care Cost Containment System (AHCCCS)
    ATTN: Provider Registration Unit
    PO Box 25520, MD-8100
    Phoenix, AZ 85002