Formulario de selección del médico de atención primaria

Use this form to choose or change your primary care doctor.

After submitting this form, the change will be effective on the first day of the following month. You should receive a Sharp Health Plan member ID card with your updated provider information 5 to 7 business days before the effective date.

Si tiene preguntas o necesita asistencia de inmediato, comuníquese con nuestro equipo de Atención al Cliente llamando al 1-858-499-8300 o a la línea gratuita 1-800-359-2002, de lunes a viernes de 8 a. m. a 6 p. m.

Please note, if you are choosing a primary care physician (PCP) in a different plan medical group — for example, you are switching from a doctor in Sharp Rees-Stealy to a doctor in the Sharp Community Medical Group — your current referrals or prior authorizations for specialists, special supplies or equipment will be voided. Debe solicitar a su nuevo PCP nuevas referencias o autorizaciones previas.

Buscar un médico

Be sure to make note of the doctor’s 10-digit Provider NPI. This ID number is required to complete the form.

* required field

You can find this on your ID card or by logging in to Sharp Connect.

This 10-digit ID number can be found in the provider search results. Select the Search for a Doctor button above.

Razón por la que solicita el cambio*
¿Actualmente es usted paciente del médico que está solicitando?*

If different from above

If different from above