Use Provider Data Profiles for faster, more streamlined practitioner enrollment notifications and updates all in one place. You can add practitioners, update clinic affiliations, remove departing practitioners, generate shareable PDFs and check the status of your submissions.

If a practitioner is not in the Provider Data Profiles, use the Minnesota Uniform Practitioner Change form (PDF), with the Site Location Addendum page if applicable and email it to us. For dental providers, use the Dental Contracted Provider Change Notice (PDF).

Email change forms to ProviderData@HealthPartners.com.

• Practitioners eligible for a National Provider Identifier (NPI) must submit both an NPI and license to complete enrollment with HealthPartners.
• Always use the most current approved version of the Minnesota Uniform Practitioner Change form; we can’t accept outdated versions.
• Submissions made via the Minnesota Uniform Practitioner Change form may take up to 30 days to process and don’t include status updates.
• Use a secure, encrypted email service when sending private or protected information.