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New Procedure for Submitting Demographic Changes

Audience: All Providers

Keeping your practice information up to date is very important.  Not only do we share your practice information with patients in our provider directories, but having current information is also critical to our ability to conduct business with you.

Effective immediately, all demographic changes should be submitted directly to our Provider File Maintenance department using the most current Practitioner Demographic Changes form available at Please do not mail, fax or email the form to your Provider Relations representative.

The most convenient way to submit your Practitioner Demographic Changes form is online via our website. Under the Resources tab, click on Update Practice Information. Fill out the form and save it to your computer. Login to the secure portion of our website and you will be able to send it to us electronically. If do not have access to the secure area, you will need to follow a few quick registration steps to create an account.

We encourage you to submit your changes using the online form for the fastest, most efficient service; however, completed forms will be accepted by mail or fax to the following:

Univera Healthcare

165 Court St.

Rochester, NY  14647

Attention: Provider File Maintenance

(Fax) 1-800-676-6285


 Thank you in advance for your cooperation as we continue to improve our service to you. If you have questions, contact your Provider Relations representative.

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