HIPAA provisions for all healthcare providers require National Provider Identifiers (NPIs). Individual healthcare providers, hospitals, pharmacies, schools, and group practices are assigned a government-issued, standard identification number.
You can find it at NPI registry. HIPAA-compliant transactions require it:
- Information about claims and encounters
- Status of claims
- Paying premiums and coordinating benefits
- Enrollment, disenrollment, and eligibility
- Remittance and payment advice
- Authorizations and referrals
HIPAA specifies that an NPI number is required before submitting claims or conducting other transactions. All health plans use this 10-digit number that does not expire or change.
What do you do to know about applying for an NPI?
In the future, healthcare providers will save time and headaches by applying for an identifier. There are three ways to obtain your NPI:
- Use the National Plan and Provider Enumeration System (NPPES) to enroll
- To begin the application process, select Create a Login
- Redirect to the CMS website by selecting OK
- Read the terms and conditions carefully
- Continue by pressing Accept
- Please enter and confirm your email address
- From the image, enter the security text
- Continue by pressing Submit
- CMS provides criteria for creating unique user names
- Using CMS criteria, enter and confirm a unique password
- Choose five security questions, then click on Continue
- Please enter information: First and Last Name, Date of Birth, Social Security Number, Gender, and Sole Proprietorship.
- If your credentials have been associated with another name, enter it here
- Credentials must be entered, then select Next to continue
- You will be taken to the Business Mailing Address.
- You can choose a foreign address by clicking the Foreign Address button.
- Please click the Military Address button at the top of the page if you have one.
- Make sure you spell out all street abbreviations (Courts, Lanes, Drives, etc.) if you have a regular mailing address.
- Select NEXT after entering your phone number, extension, and fax
- Following clicking next, you may see a screen similar to the one below. It could be that it doesn’t recognize the address.
- The address can be accepted, used, or revalidated.
- Select NEXT if your Business Practice location address differs from your Business Mailing address.
- To continue, select Same as Business Mailing Address.
- Enter other NPI numbers for Medicare, EMTs, or other medical professions on the Other Identification Numbers page.
- Enter all necessary information by clicking Add Identifier
- NEXT, if you have no other ID number
- Select Add Taxonomy from the Taxonomy/License Information Form
- Then select NEXT. Code: 22 Respiratory, Developmental, Rehabilitative, and Restorative Service Providers
- You must select the following classification for the Selection of Classification page: o 2255A2300X-Specialist/Technologist–Athlete Trainer.
- Select SAVE
- The page Taxonomy/License Information will reload after clicking SAVE
- You just entered a Primary Taxonomy. Please select it, then click NEXT
- An alternative contact person can be entered on the Contact Person Information page.
- It will enter the information if you choose to be the contact person at the top of the page.
- To input, the same phone number as the mailing address, click the Same As Mailing Phone button or enter a new number, and email address
- Once completed, hit NEXT
- Read the Certification Statement and select SUBMIT at the top of the page
- The confirmation page will appear once you submit your NPI number
- Keep a copy of this page
- Logout once completed, Done.
- Fill out, sign, and mail a paper NPI form
NPI Enumerator, 7125 Ambassador Road Ste 100, Mill, MD 21244.
- Bulk enumeration for Electronic File Interchange Organizations (EFIO).
CMS contractors can help you apply online, by mail, or by phone. You can track the status more efficiently by using the online application. You can find answers to FAQs on the NPPES website.
Thanks for applying
[email protected] will send you your NPI after confirmation of data receipt. Spam filters on email interfaces may intercept the reply from the NPI Enumerator with your NPI and confirmation message. Keep an eye on this folder.
NPI receipt
Obtaining an NPI depends on whether the application was submitted electronically or on paper, whether it was complete, and whether it passed all edits. An NPI can be issued in ten days to a provider who submits an electronic application and takes 20 business days to process.