Close

Provider Application

If you are a Primary Care Provider, please be sure to review the Primary Care Provider Criteria before completing the Application.

Provider Application

Please remember to sign the Application and the Consent for Release of Information and return them with the attachments to the Amida Care Offices:

Amida Care, Inc.
248 W. 35th Street, 7th Flr
New York, NY 10001

NOTE: PLEASE SUBMIT ALL DOCUMENTS AND ANSWER ALL QUESTIONS

Please call the Provider Services Department at 1-800-556-0674 if you have any questions.

Amida Care is an NYS sponsored HIV Special Needs Plan (SNP) that provides health care services for people on Medicaid living with HIV and their children. Amida Care services Manhattan, Brooklyn, the Bronx and Staten Island. Starting September 1, 2010, if you live in New York City, choosing a Special Needs Plan or a regular Medicaid managed care plan is mandatory for PLWHA. To learn more about HIV SNPs, call NY Medicaid CHOICE helpline at 1-800-505-5678. (TTY 1-888-329-1541)

© Amida Care, 2011 Amida Care, Inc., 800-556-0689
TTY 800-662-1220  |  info@amidacareny.org 
Privacy Policy  |  DONATE