The Department of Health and Human Services has adopted a mandatory, unique health
identifier, the National Provider Identifier (NPI), to be used by health care professionals
and organizations in HIPAA standard electronic transactions.
The NPI is a unique 10-digit identifier that health plans, clearinghouses, and
providers must use for electronic transactions to be in compliance with HIPAA. What
does this mean? All HIPAA-covered health care providers, whether they are individuals
or organizations, must obtain an NPI; the NPI remains with the provider regardless of
job or location changes.
NPI is required on all HIPAA standard electronic transactions beginning on
May 23, 2007. There is NO COST affiliated with the mandatory requirement
of obtaining an NPI number.
The web-based application is available at:
https://nppes.cms.hhs.gov
You can also submit a paper application to the Enumerator. The Enumerator’s
address is available at: https://nppes.cms.hhs.gov or
by calling 1-800-465-3203 or TTY 1-800-692-2326.
For more information and FAQ's regarding NPI, go to http://www.cms.hhs.gov/NationalProvIdentStand
More on NPI
Highlights from TC 2006 Speaker, Michael Costa of Greenberg, Traurig, LLP
The Vision of NPI:
- 1. For most health care providers the NPI means receiving one unique number for life
- 2. There is no cost to apply for the number
- 3. NPIs are obtained from NPPES
Types of NPI:
- Type 1 – Individual NPI: An individual health care provider may obtain a single NPI to identify
the person for life
- Type 2 – Organizational NPI is a provider that is not an individual. It is a legal entity such
as government, corporation, partnership. It obtains one NPI for the whole, and it may obtain
NPIs for its Subparts.
