Add new user to existing Provider account

  • By completing this information, you are certifying that you work directly for the Provider and are not a third-party biller or vendor.

  • Please note that this process will only result in a new user being created for an existing EDISS Connect account and not the creation of a new EDISS Connect account.

Please enter the following details belonging to your account to add a new user:
  • Any NPI number associated with the account
  • Submitter ID associated with the NPI entered
  • Tax ID/SSN associated with the NPI entered

Account Information

New User Details

(Username must be unique, between 8-20 characters and contain no spaces or special characters.)

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