Register as a WTC Health Program Provider
Once you submit your provider registration information through electronically accepting the Terms & Conditions, you may download a confirmation of your registration submission. Your enrollment information will be transmitted directly to the WTC Health Program, validated against the Program's data requirements, and automatically registered in the provider network database. You may confirm your registration status on the Provider Enrollment Tool as soon as 1-2 business days following submission and download a Quick Reference Provider Guide.
Review the WTC Health Program Provider Enrollment Tool Instructions
Last 5 Digits of Provider Tax ID
PTAN (Provider Transaction Access Number)
As the requestor of this provider registration status, please provide your contact information:
Business Name
Your First Name
Your Last Name
Phone Number
Email Address
Confirm Email Address
Relationship to Provider (Ex: Self, Consultant, Employee, Administrative Intermediary)
Title (Ex: Physician, Office Manager, Practice Owner)