Welcome to the Provider Registration Page
Please Click "Take a Tour" to see a video walk through of the registration process
If you have any questions about the registration process, Please visit our FAQ
For more information please Contact Provider Services Help Desk
Provider Information
Are you registering for:* Start Here Help Help * Help × correct
Provider Type: *
* Help correct ×
* Help correct ×
Enter any 3 of the below if you don’t know your Provider Id
Help ü ×
Help
Help
Help
     
This is a required Mandatory field for all pay to providers.
Your Molina Provider ID is a unique ID that is given to you by Molina Healthcare. This is a required field for registering. If you do not have your Molina Provider ID, please contact your Provider Services Representative.
National Provider Identifier is a unique identification number given to health care providers by the Centers for Medicare and Medicaid/Marketplace Services. If you have an NPI Number, please enter it in the designated field.
If you have a State License Number, please enter the number in the designated field.
If you have a Medicare Number, please enter the number in the designated field to access Medicare account.
If you have a Medicaid/Marketplace Number, please enter the number in the designated field to access Medicaid/Marketplace account.
This field is optional. If you have a Drug Enforcement Administration (DEA) Number, please enter the number in the designated field.
Must have at least 8 and no more than 15 characters.
Combination of letters and numbers may be used, Special characters are now limited to ONLY Period "." and the Under score "_", Should not end with Period(.)
Must have at least 8 and no more than 12 characters.
Must contain at least one uppercase and lowercase letter, at least one number.
Must have at least one number
Password cannot contain partial User ID, first name or last name
This is a required field. This is to ensure security upon creating a user account.
As a condition of participating in Molina Web Portal Access, user must agree to the Provider Online User Agreement.
Please select a state if you are registering for a medicaid/Marketplace program.
Medicaid/Dual Options.
Please select this option if you are a Medicaid, Marketplace, or Molina Dual Options (Medicare-Medicaid Plan) provider.
Submit Claim Alert
You have completed claims that have not been submitted. Do you want to submit?