National Provider Identifier (NPI) Frequently Asked Questions
The National Provider Identifier (NPI) is an Administrative Simplification Standard under the Health Insurance Portability and Accountability Act (HIPAA). For covered health care providers, the NPI is a unique identifying number.
In the administrative and financial activities required by HIPAA, covered health care providers, all health plans, and health care clearinghouses must use NPIs. The NPI is a ten-position numeric identification that is devoid of intelligence (10-digit number).
This means that the data don’t contain any further information about healthcare providers, such as where they live or what medical specialty they practice. In HIPAA standards transactions, the NPI must be used instead of traditional provider identification.
Covered providers must also disclose their NPI provider lookup with other doctors, health plans, clearinghouses, and any entity that may need it for billing purposes, according to the Federal Regulation, The Health Insurance Portability and Accountability Act of 1996.
How to Apply for a National Provider Identifier (NPI)
An identifier application is a free, easy 20- to 30-minute process that can save healthcare providers time.
You can apply online, through the mail, or with a CMS contractor.
Visit the National Plan and Provider Enumeration System (NPPES) website to apply online, read the instructions carefully, fill out the questionnaire, and submit your application. The website includes answers to frequently asked questions as well as other useful information.
You will receive your NPI through e-mail from Customerservice@NPIEnumerator.com after validation of your data receipt. The reply from the NPI Enumerator with your NPI and confirmation message may be intercepted and directed to a spam folder if your e-mail interface has spam filtering. After you’ve submitted your data, keep an eye on this folder.
It is recommended that you utilize the online application because it is often faster and easier to track the status. If you’d rather submit a paper application, call the NPPES customer care hotline at 800.465.3203 and ask for a paper application form.
Who gets a National Provider Identifier (NPI)?
NPIs will be assigned to health care providers who require them to submit claims or carry out other HIPAA-mandated transactions. An individual, group, or institution that offers medical or other health services or supplies is referred to as a “health care provider.” This includes the following:
- physicians and other practitioners
- physician/practitioner groups
- institutions such as hospitals
- laboratories
- nursing homes
- dental providers