Manage Physical Address
Revised: January 16, 2024
Overview
If you are in an organization provider, your physical address is the address of your practice facility. If you are an individual practitioner, your physical address is the address of your primary practice location.
On this page, you can view and edit your physical address information. You can only edit the information on this page if you are in an MPSE Request.
Portfolio/Profile Information
See Portfolio/Profile Information on the Recurring Items page of the Minnesota Provider Screening and Enrollment (MPSE) User Manual.
Enrollment Record Information
This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Enrollment Record Information on the Recurring Items page of the MPSE User Manual.
Physical Practice Address
In the Physical Practice Address section, provide your physical practice address and identify which types of information you would like mailed to this address.
Street Address 1
Type your primary practice address in the Street Address 1 field. Your address must be a physical address. Minnesota Health Care Programs (MHCP) will not accept a PO Box for your physical address.
Street Address 2 Type
Select your address type from the Street Address 2 Type drop-down list. Street address type is required if you have typed information into the Street Address 2 Data field. If you have not typed data in the Street Address 2 Data field, then it is optional to select a street address 2 type.
The options you can select are:
Street Address 2 Data
Type your street address data into the Street Address 2 Data field. For example, if you select Apt. as your street address 2 type, type your apartment number in the Street Address 2 Data field.
Only type information in this field if you selected a street address 2 type.
City
Type the name of the city of your physical practice address in the City field.
State
Select the state of your physical practice address in the State drop-down list.
Zip Code
Type the 5-digit zip code of your physical practice address in the ZIP Code field.
County/Tribe
Select the county or tribe of your physical practice address from the County/Tribe drop-down list. This option only appears if you select Minnesota from the State drop-down list.
Home Address
Use the option buttons in the Home Address field to indicate if your physical address is a residential address. Select the Yes option if your physical address is also a residential address. Select the No option if your physical address is not a residential address.
Include in Directory
This field only appears if you selected Yes in the Home Address field. Use the option buttons in the Include in Directory field to indicate if you would like your physical practice address included in the MHCP Provider Directory.
Select the Yes option if you want your physical practice address included in the MHCP Provider Directory. Select the No option if you do not want to include the physical practice address in the MHCP Provider Directory.
Available Address Usage Types and Selected Address Usage Types
The Available Address Usage Types box and the Selected Address Usage Types box are used to designate how MHCP will use the address provided on the Manage Physical Address page.
If this is your first time adding an address on this page, all the options available to choose from will be in the Available Address Usage Types box including 1099, Credentialing, Authorizations, Paper Check, Remittance Advice, Practice Location, File Location, and Correspondence.
To designate which types of information you would like sent to your physical practicing address, you must move your options from Available Address Usage Types to Selected Address Usage Types. To move an item from one box to the other box, click the name of the usage type.
The only address usage type that is required to be added to the Selected Address Usage Types box is Practice Location. If you keep any address usage types in the Available Address Usage Types box, you will be required to add one or more additional address on either the Manage Mailing Addresses page or the File Location Address page.
Continue
Click Continue to save your changes and go to the next page.
Cancel
Click Cancel to go back to the previous page.
Report this page