Apply to Become a Provider

Step 1: Review the DDD Policy Manuals

Before applying to become a Medicaid/DDD approved provider, it is important to understand the policies and procedures that govern the delivery of services in the DDD Fee for Service system. Please take time to review the policy manuals for each of the Division's two Medicaid waiver programs:

Step 2: Apply for an NPI Number

The National Provider Identifier (NPI) is a unique 10-digit identification number issued to health and human service providers in the United States by the Centers for Medicare and Medicaid Services (CMS).

You need to apply for an NPI for each location from which you plan to provide services. If the services you provide are community based and not provided through a specific location (Community Based Supports or Supported Employment, for example), apply for an NPI for the main location (administrative office).

Step 3: Submit the Combined Application

Once you obtain your NPI(s), you may complete the Combined Application to Become a Medicaid/DDD Approved Provider*.

Please Note:

  • Providers of Day Habilitation, Support Coordination, and Supports Brokerage services must take the added steps below before and/or during the combined application process.
  • Providers of Individual Supports (residential or in-home) must sign and submit the Attestation for Individual Supports Form.

Mail your completed application, together with any required documents for the service(s) you are applying to provide, to:

   Gainwell Technologies
   Provider Enrollment Unit
   PO Box 4804
   Trenton, NJ 08650-4804

*Please retain a copy of your original Combined Application. 

If you have questions or need help:

Before submitting the Combined Application, agencies interested in providing Day Habilitation services must apply for and receive Provisional Day Habilitation Certification.

Before submitting the Combined Application, agencies interested in providing Support Coordination services must:

iRecord Access for Approved Support Coordination Agencies

Support Coordination Agencies approved to provide Support Coordination services can request access to the iRecord. For the initial request for iRecord access, the Support Coordination Supervisor must complete the iRecord Request Form, scan it, and email it to DDD.ITREQUESTS@dhs.state.nj.us. A username and temporary password will be sent to the Support Coordination Supervisor, including instructions on re-setting the initial temporary password.

After the initial account is set up, the Support Coordination Supervisor can log into the iRecord and request additional users.

Change your iRecord password

Before submitting the Combined Application, agencies interested in providing Supports Brokerage services must:

If you have questions or need help, please contact the DDD Office of Education on Self-Directed Services by email at DDD.OESDS@dhs.nj.gov.