Register Now

Connect to SecureCare’s network of providers:

To join SecureCare simply complete the registration form on the right side of this page. Once you click submit, you will receive acknowledgement your information was sent. In the coming days, you will receive enrollment documents to the email address provided.

Minnesota Guidelines and Forms

SecureCare Minnesota Credentialing Eligibility Criteria and Rights

Credentialing

Contacts

Payer & Provider Services
providerservices@securecarecorp.com
402-934-4744 x1

Credentialing
credentialing@securecarecorp.com
402-934-4744 x3

Name * Required
First Last
Practice Name * Required
Practice Address * Required
Street Address County City State ZIP Code
Office Phone * Required
Individual NPI number (no dashes)
Group NPI number (no dashes)
Practice TIN * Required
Email * Required
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Group Administrator * Required
First Last
Practice Name * Required
Practice Address * Required
Street Address County City State ZIP Code
Office Phone * Required
Practice TIN * Required
Email * Required
Please provide the names, degrees (DC/PT only) and NPI numbers for all providers in your office * Required
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