SAMPLE for the demonstration: a fictional certificate, not a real document. In real use this is the scan or PDF the coordinator attaches.

Payer enrollment

Ridgeline Health Partners credential file

Issued toDr. Samuel Ortiz, MD
CredentialPayer enrollment (MCR)
NumberMCR-ENR-DEMO-4075
Issued byMedicare
Valid fromFeb 21, 2024
Valid throughFeb 21, 2029

Fictional provider and number. Close this tab to return to the Credential Tracker.