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 toCaleb Foster, PA-C
CredentialPayer enrollment (MCR)
NumberMCR-ENR-DEMO-4098
Issued byMedicare
Valid fromSep 17, 2024
Valid throughSep 17, 2029

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