National Provider Identifier (NPI)
The administration simplification provisions of HIPAA require the Secretary of Health and Human Services (HHS) to adopt a national standard identifier for covered health care providers. The National Provider Identifier (NPI) will be the standard identifier and CMS is developing the National Plan and Provider Enumeration System (NPPES) to identify providers and assign NPIs.
The NPI is ten-digit number and is used to submit claim transactions to all government and non-government payers. NPI replaced existing provider numbers assigned by these entities and CMS will discontinue the UPIN enumeration process.
Providers who are required to obtain an NPI include:
- non-physician healthcare practitioners
- other suppliers and certified providers such as institutions
- home health agencies
- skilled nursing facilities
Each individual practitioner will receive one NPI. However, an organization provider may obtain an NPI for each of its subparts.
A subpart can be considered:
- a separate physical location of an organization health care provider
- member of a chain
- an organization health care provider separately licensed or certified
For additional informational and to complete an application, visit https://nppes.cms.hhs.gov on the Web.