Add Clinicians Practice Information Practice Name * Taxpayer Identification Number (TIN) * Accreditation Number * Clinician Information Clinician First Name * Clinician Last Name * National Provider ID * Submission * MIPS 2022 Submission Next Clinician Information Clinician Name * Clinician Last Name * National Provider ID * Membership Type * Choose Membership Type MIPS 2022 Submission × Edit Clinician First Name * Middle Initial Last Name * Clinicians Email * National Provider ID * Provider Type * Choose Provider Type Physician Fellow Physician Resident Physician Physician Assistant Nurse Practitioner Registered Nurse Membership Type * Choose Membership Type MIPS 2022 Submission Save changes
