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New Eyecare Professional Enrollment

If you are interested in becoming an NVA Eyecare Professional, please fill in the following information and click 'Send' to submit the request. You can also e-mail us directly at newproviders@e-nva.com. An NVA representative will contact you to discuss the details.
Fields marked with * are required.
Specialization:*
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State:*
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Medicaid/Medicare:*
 
Are you currently a Medicaid provider? -
Are you currently a Medicare provider? -
 
Once your request is reviewed you will be notified by email. If accepted, you will be required to complete a W9, NVA Contract and Frames Inventory, if applicable and apply through the Council for Affordable Quality Healthcare (CAQH) or submit a credentialing application. If applying via CAQH please ensure that you grant NVA access to your CAQH record. If you are not participating with CAQH, you may go to the CAQH web site to complete an application. Please note there may be additional requests.
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