What is an NPI number?

If you are here, you probably know what the NPI directory is. In case you don’t, here’s the quick overview and maybe you’ll learn something new.

What is the NPI number?

A National Provider Identifier or NPI is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).

The NPI is a single identification number that will be issued by the federal government to health care providers. It is intended to improve the efficiency of the health care system and help to reduce fraud and abuse.

What is NPI Lookup?

The NPI Registry Public Search is a free directory of all active National Provider Identifier (NPI) records. Healthcare providers acquire their unique 10-digit NPIs to identify themselves in a standard way throughout their industry.

Is the NPI Registry Lookup Accurate

No. It’s a good start but don’t rely on it to be correct. Many of the entries are old. Like really really old. It’s not uncommon to see entries that are more than 10 years old. The only thing more outdated than the NPI registry data is that Tattoo your grand dad got in the 60’s. There, you learned something new.

Who is required to obtain a National Provider Identifier?

All Individuals and Organizations who meet the definition of health care provider as described at 45 CFR 160.103 are eligible to obtain a National Provider Identifier, or NPI. If you are a HIPAA covered provider or if you are a health care provider/supplier who bills Medicare for your services, you need an NPI.

What is the NPI number used for?

The NPI is a unique identification number for health care providers that will be used by all health plans. Health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions specified by HIPAA.

What is the difference between Type 1 and Type 2 NPI?

Type 1 NPIs are healthcare providers, such as physicians and dentists. Type 2 NPIs are organizations such as facilities, hospitals, home health agencies, labs, and DME suppliers.

Do all providers have an NPI number?

Individuals (doctors, nurses): One NPI per provider regardless of numbers of practice locations, contracts, etc. Hospitals (nursing facilities, etc.): One NPI or some/all subparts may also need to have NPIs. Hospitals should obtain separate NPIs for each Medicare A number.

Do NPI numbers have expiration dates?

No. NPIs are issued by the National Plan & Provider Enumeration System (NPPES). The NPI contains no embedded intelligence – no coding that would identify the dentist’s state or license number, for example. It is simply a random number that does not expire.

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