Physician Onboarding Practice Name Practice Address Best Contact # Email Years in Practice Tax ID NPI Number Other Provider # and Payer Specialty Physicians in Practice Total Number of Patients What sets you apart from other Physicians in your area? What Continuing Education/Certification Programs have you taken? Do you have high Patient Satisfaction/Positive Reviews? Do you provide any Specialty Services or Services for Specific Groups? Have you had any added per-patient expenses due to COVID-19 related changes? This can include added disposable PPE costs per patient. Most Common CPT Codes and Frequency: