Credential Profile
Item | Description | Where / how it is used |
First Name | Individual’s first name | Printed on the treatment log as the first name of rendering provider (or UDO/USO supervisor) |
Last Name | Individual’s last name | Printed on the treatment log as the last name of rendering provider (or UDO/USO supervisor) |
Signature | The full name, title and credentials that the individual uses when signing their name for treatment logs | Printed on the treatment log as the signature of rendering provider (or UDO/USO supervisor) |
Item | Description | Where / how it is used |
NPI | The individual’s personal NPI. Should not be their organizational one. | Printed on the treatment log as the NPI for the individual that was the rendering provider or UDO/USO supervisor. Sent to Medicaid as the Attending provider |
Item | Description | Where / how it is used |
Profession | The specific profession - Speech and Language Pathologist
- Physical Therapist
- Physical Therapist Assistant
- Licensed Clinical Social Worker
- Licensed Master Social Worker
- etc
| Printed on the treatment log as the profession of the rendering provider or UDO/USO supervisor Used to determine whether the individual possesses the credentials to provide the service and whether a UDO/USO signature is required. Used to determine whether meets the list of allowed professions to be Medicaid billable Printed on Medicaid Cost Report Supplemental form Can be submitted to Medicaid for affiliating practitioners |
License Number | The six digit License Number | Printed on treatment log as the license of the rendering provider or UDO/USO supervisor Printed on Medicaid Cost Report Supplemental form Can be submitted to Medicaid for affiliating practitioners |
Date of Licensure | The original date NYS issued the license to the individual. | Used to determine which dates of service are valid for this license. For example a CFY that transitions to an SLP or an OTA that later becomes an OT. The system can determine which dates of service require a UDO/USO co-signature and which ones they were fully qualified to perform solo. |
Registered Through date | The date that the license is currently registered through. The individual needs to re-register their license every few years. | Used to determine which dates of service are valid for this license. |
Item | Description | Where / how it is used |
Profession | The non-licensed profession - Teacher
- Certified School Psychologist
- Music Therapist
- CFY
- TSHH
- TSLD
- Etc.
| Printed on treatment log Used to determine if Medicaid eligible if under UDO/USO (CFY, TSHH, TSLD, etc.) |
For those who do not have a CPSE Portal login, the following link will be used:
- Enter NPI, Profession, and License Number.
- Select “Proceed to Verification.”
The verification screen has three main sections
- The list of information from their profile (name, NPI, license, etc.) that needs to be verified and attested that it is correct (upper left)
- The information for their license as it appears on the NYS Office of the Professions website (right hand side)
- The information from the National NPI Registry for their NPI (bottom left)
- Be sure to compare the two exactly, as you will be attesting that the information in the Portal is accurate.
- If any of the data, aside from signature and license dates is not correct or is missing, you should contact the agency you work with.
(The categories circled in red must match each other as well.)
- Once you have confirmed that all of the data is accurate and all of the “verify” boxes are checked, click “I attest.”
- Here, the successful verification is shown with the option to print.
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Article ID: 151, Created: 7/2/2018 at 4:19 PM, Modified: 7/26/2024 at 10:32 AM