Provider Registration   Skip portlet
To obtain a user id and password, Providers and Trading Partners must have an approved enrollment with North Dakota and have received their Provider or Trading Partner ID.


Documents & Forms
The following manuals are available. PDF format files can be read using the free Adobe Acrobat Reader from Adobe.

Note: Please be aware that documents may be updated periodically. If you save a document to your computer please check back
  periodically for updates.

Publication Date  Documents and Forms File Size  File Type 
10/01/2013 SFN 1168-Ownership Controlling Interest & Conviction Information 1230k PDF
02/01/2013 SFN 615-Medicaid Program Provider Agreement 388k PDF
08/10/2018 Voluntary Product Accessibility Template (VPAT) 66k PDF

Publication Date File File Size File Type
08/21/2014 Enrollment FAQ 220k PDF
10/09/2015 Managing Provider User Security Fact Sheet 1.41mb PDF