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Provider data validation

Aetna is required to validate each participating provider’s demographic information and certain other information that is displayed in our online provider directory.

  • If NO changes are needed, please complete the online confirmation form below. Once complete, we’ll automatically update our records to show your validation is done. 
  • Be sure to include a contact name and phone number so we can follow up if we require any additional information.
  • All fields marked with a RED asterisk (*) are required in order to proceed.
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1) Information


Please select Social Security number ONLY if you do not have an Employer ID number.

Tax ID help>

Help with PIN prefix>

Help with PIN>

*Entity type
*All information on validation form is correct
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Contact Information

2) Contact Information


You also can fax your information to the number we provided in your validation letter. 

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