Network Provider Information Form

In addition to the CAQH credentialing application, TRICARE network provider applicants (does not apply to non-network providers) must also submit a supplemental Provider Information Form or PIF. This supplemental application requests information unique to TRICARE that is not addressed within the CAQH application.

Note: Do not use this form to update demographic information. This form is for credentialing purposes only. Please review our FAQ on how to update demographic information

  • Provider groups: Provider groups with 20 or more individual providers can complete the TRICARE Provider Group Roster rather than a PIF for each provider.  

We require 30 days to process new PIFs. Please allow for this time frame before contacting us regarding your application status. Keep in mind, the full credentialing process takes, on average, 60–90 days from the date we receive a completed application. You can check status using our Check Credentialing Status tool.

You may mail or fax your completed PIF.

If faxing, use the fax cover sheet included in the form as the first page of your fax. Applications that do not have this cover sheet as the first page of the fax will not be processed.

Mailing Address:
Health Net Federal Services, LLC/TRICARE
Attn: Provider Network Management
PO Box 9410
Virginia Beach, VA 23450-9410


  • Created: May 28, 2019
  • Modified: May 28, 2019
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