Fidelis Care New York Provider Request Form

Fidelis Care New York Provider Network On-Line Request for Participation

Fidelis Care is now accepting Primary Care and Specialist Physician Requests. Fidelis Care has moved to a paperless environment and we expect all prospective providers to be able to accommodate paperless interfaces. Click here for more information.

Primary Care Providers must abide by the Access and Availability rules outlined in the on-line Provider Manual, Section 4. Please click here for more information.

We appreciate your inquiry in becoming a participating provider in our network. Due to the high volume of requests, we are experiencing some delays in responding to those inquiries. Please be assured we have received your request and will respond as soon as we are able.

Click here to complete the Inquiry form.

All other requests will be reviewed and considered on an as needed basis.

If you are already participating with Fidelis Care, please contact Provider Services at 1-888-FIDELIS (1-888-343-3547) for assistance.

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