Register a User Account

USER

USER TYPE:
 
USER NAME:
(required)
PASSWORD:
(required)
CONFIRM PASSWORD:
(required)
 
 
FIRST NAME:
(required)
LAST NAME:
(required)
PHONE:
 
EMAIL:
(required)
MAILING ADDRESS:
(required)
CITY / STATE / ZIP:
(required)

PROVIDER DETAIL

DESIGNATION:
 
 
 
NPI:
(required)
TIN:
(required)
PHYSICIAN SPECIALTY:
 
FOR RADIOLOGISTS    
RAD SUBSPECIALTIES:
 Add another subspecialty ...
RESULT IDENTIFIERS:
 Add another identifier ...

ORGANIZATION

 
 
SEARCH:
 
  (search by name or TIN)  
ORGANIZATION TYPE:
 
ORGANIZATION NAME:
(required)
TIN:
(required)
NPI:
(required)
MAILING ADDRESS:
(required)
CITY / STATE / ZIP:
(required)
PHONE:
 
FAX:
 
EMAIL ADDRESS:
 

CHARACTERS

To prevent malicious behavior please enter the characters seen below.

Next Steps...

Once you have registered your account you will need to:
  1. Identify each health plan you are affiliated with.
  2. Describe each of your imaging locations and their capabilities.
  3. Describe your organization's quality processes.

TERMS AND PRIVACY

Please read and accept the terms of service and privacy policy.

How To…