For covered health care providers, the NPI is a unique identifying number. It’s a numeric identifier of ten digits. Covered entities must use NPI numbers in regular transactions under the HIPAA act.
The NPI must be used in all regular transactions by health insurance providers, health plans, and health care clearinghouses. The goal of NPI is to increase the efficiency and effectiveness of electronic health information transfer.
What is the purpose of NPI?
NPI has numerous advantages, including:-
- It makes it simple to identify health insurance providers, insured organizations, health care plans, and employees.
- HIPAA standard transactions can be sent in a simple electronic format.
- Coordination of benefit transactions that is efficient.
Who May Obtain an NPI?
An NPI should be issued to all health-care practitioners (that is, doctors, manufacturers, hospitals, and others). Health service providers, persons, or organisations providing health care (CFR) must have an NPI, according to section 160.103 of the 45 Code of Federal Regulations.
Obtaining an NPI
The National Plan and Provider Enumeration System (NPPES) generates National Provider Identifiers, which are granted by the US Department of Health and Human Services (HHS) through the Centers for Medicare and Medicaid Services (CMS).
Providers can get an NPI by contacting NPI Enumerator or by applying online.
Web (NPPES): https://nppes.cms.hhs.gov
Email: at firstname.lastname@example.org
Phone: 1- 800-465-3203
Mail: NPI Enumerator
PO Box 6059
Fargo, ND 58108-6059
Who May Not Obtain an NPI?
A National Provider Identifier, or NPI, is available to all individuals and organisations who fit the description of a health care provider as defined by 45 CFR 160.103.
You’ll need an NPI if you’re a HIPAA-covered provider or a health care provider/supplier who bills Medicare for your services.
The NPI and NPPES Downloadable File Registry are provided by the National Plan and Provider Enumeration System (NPPES), which assigns NPIs, maintains and updates NPI health care provider records, and distributes the NPI and NPPES Downloadable File Registry.
The NPI number can also be found on a variety of websites, including the ones listed below.