Change Your Primary Care Physician (PCP) | Contact Us

Your relationship with your primary care provider (PCP) is very important. You may change your PCP at any time by submitting the form below or by calling SummaCare Member Services at the number listed on the back of your member ID card. Please note that you must continue to see your current PCP until your request to change has been processed.

To locate the PCP code for your new provider, please use our Find Your Doctor tool. Enter your search criteria, then click on the provider name to open his/her information and locate the code.

Member ID Number (located on your ID card)

Group Number (located on your ID card)

First Name

Last Name

Middle Initial

Address

City

State

Zip

Phone

Email Address

Reason for Changing

New Primary Care Provider Information

Provider's Name

PCP Code

Requested Effective Date of Change

State

Zip

Provider's Phone

Change Your Primary Care Provider (PCP)

New Primary Care Provider Information

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