Frequently Asked Questions About National Provider Identifiers
A National Provider Identifier (NPI) is a unique 10-digit identification number that the Centers for Medicare and Medicaid Services (CMS) issues to U.S. health care providers. The NPI system was created to improve the effectiveness and efficiency of electronic transmission of health information, and covered health care providers and plans must use NPIs in their financial and administrative transactions.
Here are some frequently asked questions about NPIs:
- Is there any pattern to the assignment of NPIs?No, there is no intelligence behind NPIs, such as the state in which health care providers operate or their medical specialty. NPIs are random numbers that are unique to the provider.
- What are NPIs used for?These identifiers uniquely identify health care providers such as physicians, hospitals and suppliers in transactions including claims, prescriptions, coordination of benefits and inpatient medical record systems.
- How can you get an NPI? You can apply online at this website or call 800-465-3203 to request a paper application.
- Which healthcare providers must obtain an NPI?Those providers who are covered under HIPAA must get an NPI and use it in HIPAA transactions.
- Is an NPI mandatory in order to enroll in Medicare?Yes – a Medicare enrollment application without an NPI will be rejected.
- What are the benefits of an NPI? Some benefits include the ability to perform simple electronic transmission of HIPAA standard transactions, efficient coordination of benefit transactions and having standard and unique health identifiers for health care providers, plans and employers.
- Must my personal information such as address and telephone number be available in the NPI database? The information in the database comes from the information that you supplied when applying for an NPI number. However, you can request to have NPI data removed. But NPI lookup service will still be available with your NPI number, city and state of practice along with credentials and your primary specialty.
Read the CMS online publication NPI: What You Need To Know for more information.
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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.