News & Analysis
Health Care Professionals
Log In/Register

I would like to log in/register:

NPI Submissions

Use this form if you are submitting NPIs for five or fewer providers. 
OR
Request the NPI submission spreadsheet if you are submitting NPIs for six or more providers.

All fields marked with a RED asterisk (*) are required in order to proceed.

Contact Information
/
/
-
-
NPI Information

Please select the number of NPIs and enter the required information for each below.

Provider 1

Please do not use hyphens

/
/

Name (individual/organization)

Primary service location information

Primary billing location information

NPI information

First number cannot be a zero

NPI usage (how are your using this NPI)

Information Sessions

You will receive a confirmation after clicking the "Submit" button if your request has been sent successfully.



Important! Please check this form carefully before clicking on the "Submit" button. Some browsers will not keep your information, and if you do not fill in all the required fields, you will have to complete the entire form again.

News
You are now leaving the Aetna website.

Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.

Continue >
IMPORTANT:
You must use Internet Explorer 10 or above, Firefox or Google Chrome to successfully complete and submit an online form. 

Older versions of Internet Explorer are not compatible.

OK >