User Account Information
Fields marked with
*
are required
*
First Name
*
Last Name
*
Email Address
*
Practice / Organization Name
*
State/Territory
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UM
VI
UT
VT
VA
WA
WV
WI
WY
*
Phone
(xxx-xxx-xxxx)
Phone extension
(Optional)
*
Number of Clinicians
*
Submission Type
Report as an individual(s) - multiple individual clinicians can use the same account to report MIPS. The MIPS scoring will be based on each individual's performance.
Report as a group - Each eligible clinician participating in MIPS via a group will receive the same MIPS score based on the group's performance:
Individual(s)
Group
Virtual Group
Clinical data registry
Clinical data registry group
Specialized registry
Specialized registry group
Primary Care First
APM Performance Pathway
Web Interface
*
Choose a username:
(minimum of 3 characters)
*
Choose a good password:
(minimum of 12 characters)
*
Re-enter password for verification:
Please create only one account per group
By clicking 'Continue' you are indicating that you have read and agree to the terms and conditions of our "
Software License Agreement
" and "
Business Associate Agreement
" on behalf of the clinician(s), group(s) and organization(s) being reported.
Once an account is created with our registry, MDinteractive should send you a confirmation email.
If an email is not received, contact MDinteractive at 800-634-4731.
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