A National Provider Identifier (NPI) is a 10-digit numerical identifier for health-care providers. It has a countrywide scope and is specific to the provider.
Previously, a provider had a unique identification number for each payer; however, beginning May 23, 2007, a provider will have a single identifier that will be used by all payers.
The number itself is not a “smart” number, i.e., there is no intelligence built into it (e.g., a phone number is intelligent because starting with area code provides some indication of location).
What is the purpose of NPI?
The tool for NPI lookup is a unique identifying number that the federal government will assign to health-care professionals. Its goal is to boost the health-care system’s efficiency while also reducing fraud and abuse.
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 entity that offers medical or other health services or supplies is referred to as a “health care provider.” This includes:
• physicians and other practitioners • physician/practitioner groups • institutions such as hospitals • laboratories • nursing homes • dental providers • suppliers such as pharmacies and medical supply firms and others.
What is NPI numbers for doctors?
There are two types of NPI. Type 1 NPI and type 2 NPI. All individual practitioners such as doctors, dentists, nurses, pharmacists, physical therapists, and physicians have type 1 NPI. Group practitioners such as ambulance Companies, clinics, group practices, health maintenance organizations (HMOs), home health agencies (HHAs), and hospitals uses Type 2 NPI.
How is an NPI number used?
The NPI is a unique identifying number that the federal government will assign to health-care professionals. Its goal is to boost the health-care system’s efficiency while also reducing fraud and abuse.