Update your Federal Tax ID Number

Group administrators must submit changes in writing to update the Federal Tax ID Number on their provider record.

Use this Provider Change Form [PDF] to change your payment (remittance) address, tax ID number, or national provider identifier (NPI) number.

Be sure to include a future effective date for the payment change. NOTE: If you change your tax ID or NPI number, we’ll terminate your current HMSA contract and provider ID number and will issue a new contract and ID.

Please send your written notifications to the following address:

HMSA

Provider Operations – 7-PO

P.O. Box 860

Honolulu, HI  96808-0860

Email: provider_data@hmsa.com

Fax: 808-948-8210 on Oahu

RELATED LINKS

• Updating Your Provider Record
• Provider Information Forms
• Provider Change Form [PDF]

Revision History