Credentialing & Enrollment

Leaving a Group Practice: What Happens to Your Credentialing

What goes with you, what stays with the group, the clocks that start the day you move, and a checklist from before notice to your first week at the new practice.

When you leave a group practice, your personal credentials go with you (your Type 1 NPI, CAQH profile, state license, DEA registration and individual Medicare enrollment) but your participation under the group's payer contracts does not, because those contracts belong to the group's tax ID. At the next practice each payer has to link you to the new group, or contract with you directly if you go solo. Nothing has to start from zero, and nothing moves on its own.

This page is written for the clinician who is leaving. If you are the group hiring someone, the same move from your side is on how to add a provider to your group.

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Last updated October 23, 2026. Reviewed by Jacob Greenberg, ClaimCarePro.

What transfers and what does not

Each item, who owns it, what you do when you leave, and the clock that applies. Sources read October 23, 2026.

What a departing clinician keeps versus what stays with the group, with action and deadline
Item	Who owns it	What to do when you leave	Timing clock
Type 1 NPI and your NPPES record	You. CMS: individuals are only eligible for one NPI	Keep the number. Update practice location and contact details in NPPES	Within 30 days of the change (45 CFR 162.410(a)(4); CMS NPI fact sheet)
State license	You	Update your address of record and practice address with the board. In Florida the licensee is “solely responsible” for it and failing to do it is a violation	At the move (s. 456.035, F.S. sets no day count)
DEA registration	You, but tied to a principal place of business	Request a modification of address (no fee, new certificate issued). A practice in another state needs a registration there	Before handling controlled substances at the new site (21 CFR 1301.12, 1301.51)
CAQH profile	You. You authorize which plans read it	Get the login if the group managed it; replace the practice location; authorize the new group’s plans; re-attest	Re-attestation every 120 days regardless (CAQH explained)
Medicare enrollment (CMS-855I) and your reassignment	The enrollment is yours. The reassignment links it to the group	End the reassignment to the old group on the 855I, section 4F (PECOS or paper); add one to the new group, or switch to your own corporation	Practice location 30 days, other changes 90 (42 CFR 424.516(d)); withdraw within 90 days if you stop participating (CMS)
Group TIN, Type 2 NPI, group Medicare enrollment (855B)	The group	Nothing to take. Your new group, or your new entity, has its own	n/a
Commercial payer contracts, rates and the group’s payer IDs	The group (signed with its legal entity and TIN)	The group removes you; the new group adds you, or you contract as your own practice. Payer by payer	Payer-specific. Blue Cross NC: report a practitioner leaving at least 30 days before (BCBS NC)
Malpractice coverage, tail, notice period, non-compete	Your agreement decides	Read your agreement; get counsel before you give notice	Contractual

The split is the difference between credentialing and participation. Credentialing is a payer verifying you: your license, training, DEA, malpractice history. Participation is the contract that lets a practice bill that payer at in-network rates, and for an employed or partner clinician it runs through the group's contract and tax ID. You keep the first kind of record; you lose the second kind of link. (If credentialing itself is new to you, start with what provider credentialing is.)

The two most expensive misses are both government clocks. Your NPPES record must be updated within 30 days of a change, and CMS states that updating NPPES does not update your Medicare enrollment (CMS NPI fact sheet). Medicare wants a change, addition or deletion of a practice location reported within 30 days and every other change within 90 (42 CFR 424.516(d)). Two records, two filings.

Do insurance contracts follow the physician?

Generally no. Here is what each payer publishes about a practitioner leaving a group.

Commercial payer contracts generally stay with the group, because the payer contracted with the group's legal entity and tax ID, and the payers publish routes for removing a practitioner from that group. What they publish:

UnitedHealthcare: My Practice Profile in the provider portal lets authorized users “add and remove physicians from your TIN” (UHC My Practice Profile). The TIN is the unit.
Cigna: routes “Practitioner & Group Changes” to fax 877.358.4301 or Intake_PDM@cigna.com, and demographic changes through CignaforHCP.com > Working With Cigna > Directory Update (Cigna contact page, Oct 31, 2025).
Blue Cross and Blue Shield: each Blue plan sets its own process. Blue Cross NC's is explicit: a practitioner leaving a group must be reported at least 30 days before the termination date, on practice letterhead with a continuity-of-care plan, signed by the practitioner if the practitioner requests removal or by the group if the group does; contract terminations need 90 days (BCBS NC). For Florida Blue and the other Blue plans, see our BCBS guide and ask your plan.
Humana: Humana Healthy Horizons in Virginia (a Medicaid plan) lists “providers leaving the group” as a change that requires notification, handled under the portal's “Terminations” tab, at least 30 days before the effective date (Humana VA). For commercial and Medicare Advantage, ask Humana; see our Humana page.
Aetna: Aetna's public join-the-network page says a separate application is submitted for each provider in a group (Aetna); we found no public commercial route for removing a departing provider. Ask Aetna provider services, or use the Availity route your group already uses. See our Aetna page.

What none of them publishes is a rule that your credentialing file carries over to a new group automatically. In practice a payer that already has a current file on you may only need to link you to the new group's contract rather than run a new initial review, but that is each payer's decision. Ask each one in writing, and keep the answer.

Two reasons the old group should remove you promptly, and why you should check that it did: the directory keeps showing you at an address where you no longer see patients, and under Medicare your billing number cannot be used by another entity (42 CFR 424.550(a)).

The departure checklist

In order, from before you give notice to your first week at the new practice.

Before you give notice

Read your agreement. Notice period, non-compete and non-solicitation, tail coverage, who keeps receivables. These are legal terms; get counsel. We do not give legal advice and this page does not either.
List every payer you are in network with through the group, including Medicare, Medicaid and Medicare Advantage plans. Ask the group's billing or credentialing staff for the roster if you do not have it.
Collect your own records: CAQH login, PECOS login (your individual I&A account), NPPES login, copies of your license, DEA certificate, board certificates and malpractice face sheets, and your Medicare PTAN. Our credentialing intake checklist is the full list; it is the same packet the new practice will ask for.
Decide the destination: another group, your own practice, or locum work. Each one changes what gets filed (next section).

At notice

Agree the last day of service in writing. Every termination filing, Medicare and commercial, needs an effective date, and the new group's filings depend on it.
Start the new practice's applications now, not after your last day. The new group (or your new entity) files the payer applications; you supply the data.

Last day

Confirm who ends the Medicare reassignment. It is the 855I, section 4F, and First Coast accepts the individual's signature (15B) or the group's authorized or delegated official (15C) (First Coast). Form detail is on Medicare provider enrollment.
Confirm the group is removing you from each commercial contract and ask for the termination effective date per payer.

First week at the new practice

NPPES: new practice location, within 30 days (NPPES).
CAQH: replace the practice location, authorize the new group's plans, re-attest.
Medicare: reassign to the new group (855I, section 4F) or set up your own enrollment; practice-location change inside 30 days.
State license and DEA: address updates.
Each commercial payer: the new group's add-practitioner request, or your own application. Get each effective date in writing before you schedule that payer's patients as in network.

Where files stall, in our casework, is bad data from the providers: an old address still on CAQH, the old group's location on NPPES, a malpractice certificate from the old group's policy. A payer that reads three records showing three practices stops and asks. Fix the records first and the applications move.

Joining a new group vs going solo vs locums

Same personal records, three different filings.

Joining another group

The new group already has its TIN, Type 2 NPI, Medicare group enrollment and payer contracts. You reassign your Medicare benefits to it on the 855I and the group asks each payer to add you to its contract. Your work is clean personal records and a signature; the group's side of the move is on adding a provider to a group.

Opening your own practice

You become the group. A new entity means a new tax ID and, if you incorporate, a Type 2 NPI for the corporation alongside your Type 1 (CMS NPI fact sheet), a Medicare group enrollment with your reassignment to it (CMS lists “switch from reassigning benefits to becoming the sole owner of your corporation” as its own scenario, CMS), and a new contract with every commercial payer you want. This is the longest path. The full sequence is in how to start a medical practice in Florida.

Locum tenens work

How a locum is paid decides how Medicare is billed. A W-2 employee can reassign to the employer (42 CFR 424.80(b)(1)); a 1099 contractor can reassign under a contractual arrangement (424.80(b)(2)), and then the entity and the clinician are jointly and severally responsible for any Medicare overpayment (424.80(d)(1)). Separately, Medicare's fee-for-time rule (formerly locum tenens) lets a regular physician bill a substitute's services with modifier Q6 for up to 60 continuous days, and lets a group cover a physician who has left for up to 60 days with a substitute who has not reassigned to it (Claims Processing Manual ch. 1 §30.2.11). Commercial payers set their own locum rules; ask each one.

Will there be a gap in billing?

There can be, and the effective date decides it.

The gap is the time between your first day at the new practice and the effective date each payer gives your new link. For Medicare, the effective date of the new reassignment is the later of the date the application was filed or the date you first furnished services at the new location (42 CFR 424.520(d)), with up to 30 days of retroactive billing (424.521(a)). File late and the days before the filing date are not billable. Commercial payers set their own effective dates and many do not backdate. Every option for those weeks, and the ones that are not options, is on billing before credentialing is complete.

The old side has a clock too. Claims for services you furnished while reassigned to the old group are the old group's to file, under that reassignment, inside each payer's timely filing limit (12 months for Medicare; others on our timely filing table). Who keeps that money is your agreement's question, not the payer's.

Patient notice is a state-board matter. In Florida, Board of Medicine rule 64B8-10.002 says that when a physician terminates practice or relocates and is no longer available to patients, notice runs once a week for four weeks in the newspaper, with a copy to the Board within one month (Fla. Admin. Code 64B8-10.002). Whether it applies to your departure is a question for counsel.

How ClaimCarePro handles a move

Your records, the new practice's filings, one log.

We start from the intake packet, reconcile NPPES, CAQH, your license and your Medicare record to the new practice address before anything is filed, and then file:

$250 per payer application per provider for each new group link or enrollment.
$1,750 per provider for the new-practice bundle if you are opening your own practice ($1,400 for each additional provider on the same group and payers).
Weekly payer follow-up on every open file, with the rep's name, the date and the reference number logged, until the payer gives an effective date in writing.

We do not promise a date; the payers set them, and how long credentialing takes lists what each one publishes. Full pricing is on provider credentialing services, and every payer we cover is on the payer guides.

Leaving a group practice: questions, answered

Does my credentialing transfer when I leave a group practice?

Partly. Everything issued to you personally goes with you: your Type 1 NPI, CAQH profile, state license, DEA registration and your individual Medicare enrollment. What does not transfer is your participation under the old group’s payer contracts, which belong to the group’s tax ID. At the new practice each payer has to link you to the new group, or contract with you directly if you go solo.

Do insurance contracts follow the physician?

Generally no. A commercial payer contract is signed with the practice’s legal entity and tax ID, and payers publish routes for the group to remove a practitioner from that contract: UnitedHealthcare’s My Practice Profile adds and removes physicians from a TIN, and Blue Cross NC asks for a practitioner leaving a group to be reported at least 30 days before the termination date. Your own credentialing file may shorten the next step; whether it does is each payer’s call, so ask.

Does my NPI change when I change jobs?

No. CMS says individuals are only eligible for one NPI, so your Type 1 NPI stays the same. You do have to update the information in NPPES, such as your practice location, within 30 days of the change (45 CFR 162.410). An NPPES update does not update your Medicare enrollment; that is a separate filing.

Who owns my CAQH profile when I leave?

The profile is yours: it is registered to you as the individual provider, and you choose which health plans are authorized to read it. If the old group’s staff maintained it, make sure you have the login before your last day, then update the practice locations, authorize the new group’s plans and re-attest.

Do I need to tell Medicare I left the group?

Yes. The reassignment of your benefits to the old group is ended on the CMS-855I, section 4F, in PECOS or on paper (the CMS-855R is discontinued). First Coast lists the individual’s signature or the group’s authorized official as acceptable signers. A practice-location change must be reported within 30 days and other changes within 90 (42 CFR 424.516(d)).

Will there be a gap in billing at my new practice?

There can be. For Medicare, the effective date of a new reassignment is the later of the filing date or the first day you furnished services at the new location, with up to 30 days of retroactive billing (42 CFR 424.520(d), 424.521(a)). Commercial payers set their own effective dates. File before your start date and get each effective date in writing.

Who bills for the patients I saw before I left?

Services you furnished while your benefits were reassigned to the old group are billed by the old group under that reassignment, inside the payer’s timely filing limit (12 months for Medicare). Who keeps those receivables, and any production pay tied to them, is set by your employment or partnership agreement.

Do I need a new DEA registration if I move practices?

DEA requires a separate registration for each principal place of business where controlled substances are handled (21 CFR 1301.12). A move is a modification of your registration’s address, requested from DEA with no fee and processed like an application (21 CFR 1301.51). The prescribing-only office exception applies only within the same state where you are registered.

Can I keep my patients or contact them after I leave?

That is a contract and legal question, not a credentialing one: non-solicitation, non-compete, notice and records terms are in your agreement, and patient-notice duties are set by your state board. Read your agreement and get counsel. In Florida, start with Board of Medicine rule 64B8-10.002.

What does it cost to move my credentialing to a new practice?

ClaimCarePro charges $250 per payer application per provider for each new group link or enrollment. If you are opening your own practice, the new-practice bundle is $1,750 per provider ($1,400 for each additional provider on the same group and payers). Every file gets weekly payer follow-up with the rep, date and reference number logged.

Sources

Every primary source on this page, read October 23, 2026.

Moving practices? Start the new practice's files before your last day

$250 per payer application per provider. $1,750 per provider if you are opening your own practice.

Start credentialing

Prefer to talk first? Call (844) 772-8902 or contact us.

Last updated October 23, 2026. Reviewed by Jacob Greenberg, ClaimCarePro.