For Providers

Elderwood Administrative Services prepares and maintains credentialing files for all Elderwood facilities. Credentialing information on new providers is gathered and maintained in a secure electronic file the facilities have access to. Once Central Credentialing has a complete credential file, the appropriate Elderwood facility is notified for privileging review. 

Please send questions, comments, and information to Credentialing@elderwood.com or fax to (716) 608-1487.

1. Download the Elderwood Medical Privileges Application and complete all appropriate areas of the application, including all relevant checkboxes and signatures.

2. Please provide a current copy of:

a. Professional License - State Registration Certificate

b. Federal DEA Certificate

c. Board Certification (If applicable)

d. Professional Malpractice or Liability Insurance Certificate

e. Certifications that apply (Infection Control, Opioid, CPR, BLS, ACLS, etc.)

f. Infection Control Certificate for NYS

g. State or Government Issued Photo Identification

h. Curriculum Vitae or Resume

i. Tuberculosis Screening (Waived if telemed only)

j. Last Influenza Vaccine or declination (Waived if telemed only)

k. COVID-19 Vaccination record when required by DOH. (Waived if telemed only)

3. The applicant must review the following care requirements and compliance information:

a. Medical Provider Code of Conduct Principles, Compliance Overview, FCA DRA Notice

b. Review corresponding documents:

o Medical Provider Requirements

o Podiatrist Requirements

o Dental Care Requirements

4. We require complete and current information before we can approve privileges or grant access to medical records. Please send all documents to Credentialing@elderwood.com or fax to (716) 608-1487 and include your contact information.

1. Download and complete the Elderwood Non-Prescribing Health Care Professional Application.

2. Please provide a current copy of:

a. Professional License - State Registration Certificate

b. Professional Liability Insurance Certificate

c. Board Certification (If applicable)

d. State or Government Issued Photo Identification

e. Current Tuberculosis Screening (Waived if telemed only)

f. Last Influenza Vaccine or declination (Must be current during flu season, waived if telemed only)

g. COVID-19 Vaccination record when required by DOH. (Waived if telemed only)

3. The applicant must review the following Medical Provider Code of Conduct Principles, Compliance Overview, FCA DRA Notice.

4. We require complete and current credentialing information. Please send all documents to Credentialing@elderwood.com or fax to (716) 608-1487 and include your contact information.