Important New NPI Process Updates

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Earlier this year, the centers for Medicare and Medicaid Services (CMS) announced welcome new updates to the National Plan and Provider Enumeration System (NPPES). Health care providers must use this system to be awarded a National Provider Identifier (NPI) number.

The changes simplify the login procedure for increased security, provide new surrogate functionality and allow for a more streamlined NPI application process and a more responsive user interface. You can read more about the updates at the CMS publication MLN Matters®.

Single Sign On for Types 1 and 2 Providers

Within the NPPES, there are two types of providers:

  • Type 1 includes individuals, including physicians, dentists and all sole proprietors.
  • Type 2 includes organizations such as physician groups, hospitals and nursing homes.

Under the new process, Type 1 providers who already have access to PECOS may login to NPPES without incident, and surrogates of Type 1 providers will have access to their Type 1 providers' NPI records.

The greatest impact is on Type 2 providers. There have been security risks including fraud and provider identity theft because of sharing of login credentials between Type 2 providers and their surrogates. The new unified login and surrogacy will help lessen these risks and also increase account security. Type 2 provider users must have Identity and Access Management System credentials to access the updated NPPES. Visit the I&A website to do so.

Other Key Updates to NPPES

  • Users are able to save NPPES applications that are not fully complete, and then continue the application at a later session.
  • Users may add more than one practice address to their NPI application.
  • NPPES "smart filters" feature only displays entries with data entered by the user to eliminate unnecessary information.
  • A surrogacy functionality allows administrative users to update NPPES records on behalf of a provider.
  • New optional data fields such as primary and secondary languages, race and ethnicity, location accessibility for patients with disabilities and hours of operation allow the user to add more information about the health care provider and practice location.

Let Us Manage All Your Payer Enrollment Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.