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Division of Developmental Disabilities

Apply to Become a Provider

Step 1: Review Policy Manuals

Before applying to become a Medicaid/DDD approved provider, it is important to understand the policies and procedures that govern the delivery of services in the DDD Fee for Service system. Please take time to review the Policy Manuals for the Supports Program and Community Care Program.

Step 2: Determine Services

If you are applying to provide Day Habilitation, Support Coordination, or Supports Brokerage, you are required to follow the added steps below. If you are not applying for one of these three services, skip to Step 3.

Added Steps for Day Habilitation Applicants

Before submitting the Combined Application, agencies interested in providing Day Habilitation services must apply for and receive Provisional Day Habilitation Certification.

Added Steps for Support Coordination Applicants

Before submitting the Combined Application, agencies interested in providing Support Coordination services must:

• Review the DDD policy manuals, particularly the sections related to Support Coordination.
• Review DDD's revised Conflict-Free Policy (revised January 2022).
• Review the Support Coordinator's Guide to Unusual Incident Reporting.
• Submit (1) an Agency Letter of Interest, and (2) an Agency Conflict-Free Policy (both on agency letterhead) by email to DDD.ProviderHelpdesk@dhs.nj.gov

Added Steps for Supports Brokerage Applicants

Before submitting the Combined Application, agencies interested in providing Supports Brokerage services must:

• Review the DDD policy manuals, particularly the sections related to Supports Brokerage.
• Review and sign the Supports Brokerage Attestation and email it to DDD.ProviderHelpdesk@dhs.nj.gov.
• Successfully complete the Supports Brokerage Orientation through The Boggs Center.

Step 3: Apply for an NPI Number

The National Provider Identifier (NPI) is a unique 10-digit identification number issued to health and human service providers in the United States by the Centers for Medicare and Medicaid Services (CMS).

You need to apply for an NPI for each location from which you plan to provide services. If the services you provide are community based and not provided through a specific location (Community Based Supports or Supported Employment, for example), apply for an NPI for the main location (administrative office).

Step 4: Submit the Combined Application

Please Note:

• Providers of Day Habilitation, Support Coordination, and Supports Brokerage services must take the added steps above before and/or during the combined application process.
• Providers of Individual Supports (residential or in-home) must sign and submit the Attestation for Individual Supports Form.

Mail your completed application, together with any required documents for the service(s) you are applying to provide, to the following:

Gainwell Technologies
Provider Enrollment Unit
PO Box 4804
Trenton, NJ 08650-4804

*Please retain a copy of your original Combined Application.

If you have questions or need help:

• Email the DDD Provider Helpdesk: DDD.ProviderHelpdesk@dhs.nj.gov
• Visit NJMMIS or call Gainwell Technologies Provider Enrollment at 609-588-6036