To change the name on your New York nursing license, mail the New York State Education Department’s Address/Name Change Form (Form AD/NAME) along with proof of your legal name change to the Office of the Professions in Albany. There is no fee unless you want a replacement wall parchment, which costs $10. Once your documents are in order, the paperwork itself takes under an hour.
What to Send as Proof
NYSED accepts one of two documentation packages. You pick whichever is easier.
The first option is a photocopy of the legal document that authorized the change (court order, marriage certificate, or divorce decree) plus a photocopy of a photo ID already updated to your new name.
The second option is two forms of identification that together bridge your old name and new name. Acceptable IDs include a Social Security Administration letter, old and new driver’s licenses, a New York State non-driver photo ID, a Social Security card, a passport, or a U.S. military photo ID.
Send photocopies only. NYSED does not return originals.
Filling Out Form AD/NAME
The Address/Name Change Form is a PDF on the NYSED Office of the Professions website.1NYSED Office of the Professions. Change Address or Name For a name change, you complete three sections and leave Section II (address changes only) blank.2NYSED Office of the Professions. Address/Name Change Form (AD/NAME)
- Section I asks for your current name as it appears on your license, your Social Security Number, date of birth, contact information, and New York State license number.
- Section III is where you write your new legal name. It also contains a checkbox to request a new parchment. If you check that box, enclose your original parchment with the application.
- Section IV is your signature and date certifying that the information is accurate.
Registration Certificate vs. Parchment
NYSED treats these as two different documents. Your registration certificate is the wallet-sized card you renew on a cycle, and NYSED sends you a new one in your updated name automatically, at no cost, after processing the change. The parchment is the diploma-style wall certificate. A replacement parchment is $10, paid by check or money order to the “New York State Education Department.”3NYSED Office of the Professions. Fees Employers and credentialing bodies rely on the registration certificate and the online verification record, so many nurses skip the parchment.
Where to Mail It
Send the completed form, your supporting documents, and (if applicable) your $10 check and original parchment to:
New York State Education Department
Office of the Professions
Division of Professional Licensing Services
89 Washington Avenue
Albany, NY 12234-1000
Copy everything before you seal the envelope in case something goes missing in transit.
How Long It Takes
NYSED does not publish a specific turnaround for name changes and asks that you wait at least six weeks before following up on any pending application.4NYSED Office of the Professions. Application Processing and Review Busy periods push toward the higher end.
You can confirm the change through the free online license verification search, which shows your name, license number, registration expiration date, and status.5NYSED Office of the Professions. Online Verification Searches This is the same lookup hospitals and credentialing offices use, so once your new name appears there, you are set for most employer purposes. To reach the Office of the Professions about a pending application, call (518) 474-3817 or use the Contact Us form on their website.6NYSED Office of the Professions. How to Contact Us
Other Records to Update
National Provider Identifier
If you have an NPI, federal rules require you to report the name change within 30 days.7Centers for Medicare & Medicaid Services. NPPES National Plan and Provider Enumeration System Missing that deadline can hold up billing, because claims submitted under a name that does not match your NPI record may be rejected. The fastest route is online at nppes.cms.hhs.gov, which requires an Identity & Access Management (I&A) account. The paper alternative is Form CMS-10114 with box 2 (“Change of Information”) checked, mailed to the NPI Enumerator.8Centers for Medicare & Medicaid Services. National Provider Identifier (NPI) Application/Update Form Instructions
DEA Registration for APRNs
Advanced practice registered nurses with prescriptive authority who hold a DEA registration update that separately. The DEA charges no fee for a name modification.9eCFR. Title 21 Chapter II Part 1301 – Modification, Transfer and Termination of Registration You can submit the change online at deadiversion.usdoj.gov or mail a written request with your name, address, and registration number as printed on your current certificate, along with your new name.10DEA Diversion Control Division. DEA Forms and Applications The DEA then issues a new certificate to keep with the old one until it expires.
Nursys and National Certifications
Nursys, maintained by the National Council of State Boards of Nursing, pulls data directly from state boards. Once NYSED processes your change, it should flow through automatically. If Nursys still shows your old name after NYSED’s records have updated, contact the New York State Board of Nursing, since the state board owns the data.11NCSBN Help Center. How Do I Change My Name on Nursys
Certifications from the American Nurses Credentialing Center require a separate written notification; the fastest route is emailing your request and supporting document to customerservice@ana.org.12ANCC. Updating Legal Name and Contact Information Other specialty credentialing bodies each have their own process, so check with any organization whose certification you hold.
Social Security, Employer, and Insurance
Update your name with the Social Security Administration before or alongside your NYSED filing. If SSA still shows your old name, your employer’s payroll records will not match federal records and W-2 processing can break down.13Social Security Administration. What Should I Do If My Employee’s Name and Social Security Number Do Not Match Internal Revenue Service Records Submit a fresh Form W-4 to your employer as well so withholding records stay consistent.14Internal Revenue Service. About Form W-4, Employee’s Withholding Certificate
If you carry professional liability insurance, notify your carrier in writing. A policy issued under a name you no longer legally hold can create coverage disputes at the worst moment. Nurses who bill Medicare directly have up to 90 days to report the change, though sooner avoids claim rejections in the meantime. Private insurers set their own timelines, so check your policy.