Anthem Blue Cross (Anthem) providers should now submit changes to their practice profile using our online Provider Maintenance Form.

Online update options include: add an address location, name change, tax ID changes, provider leaving a group or a single location, phone/fax numbers, closing a practice location, etc. Visit the form page to review more.

The new online form can be found on > Find Resources for California >  Answers@Anthem tab>Provider Forms bullet>Provider Change Forms> Provider Maintenance Form.  In addition, the Provider Maintenance Form can be found on the Availity Web Portal by selecting California> Payer Spaces-Anthem Blue Cross> Resources tab >Provider Maintenance Form.

Important information about updating your practice profile:

  • Change request should be submitted using the online Provider Maintenance Form
  • Submit the change request online. No need to print, complete and mail, fax or email demographic updates
  • You will receive an auto-reply e-mail acknowledging receipt of your request and another email when your submission has been processed
  • For change(s) that require submission of an updated IRS Form w-9 or other documentation, attach them to the form online prior to submitting
  • Change request should be submitted with advance notice
  • Contractual agreement guidelines may supersede effective date of request


You can check your directory listing on the Anthem Blue Cross: “Find a Doctor tool”. The Find a Doctor tool at Anthem is used by consumers, members, brokers, and providers to identify in-network physicians and other health care providers supporting member health plans. To ensure Anthem has the most current and accurate information, please take a moment to access the Find A Doctor tool ( and review how you and your practice are being displayed.


To report discrepancies please make correction by completing this Provider Maintenance Form online.

Featured In:
February 2019 Anthem Blue Cross Provider Newsletter - California