National Provider Identifier (NPI): Questions and Answers
1) What is the National Provider Identifier (NPI) and how do I find information on NPI?
The NPI is a single, ten-digit identification number that replaced all other health care provider identifiers-including Medicare provider identification numbers and Unique Physician Identification Numbers (UPINs)--used on Medicare claims and all other payers' standard health care transactions. All health care providers, including individual physicians and practitioners, and organizations such as group practices, hospitals, and nursing homes, are required to obtain and use NPIs in connection with all of their HIPAA standard health care transactions. These include claims; eligibility inquiries and responses; claim status inquiries and responses; referrals; and remittance notices.
The Centers for Medicare and Medicaid Services (CMS) Website dedicated to NPI issues is
http://www.cms.hhs.gov/NationalProvIdentStand/ 
Information regarding how to apply for an NPI can be obtained at
https://nppes.cms.hhs.gov/NPPES/Welcome.do
Fox Systems, Inc., the NPI Enumerator, can be reached at 1-800-465-3203 or TTY 1-800-692-2326.
2) When am I required to have my NPI for purposes of Medicare provider enrollment?
The NPI does not eliminate the Medicare enrollment process. Providers still need to apply for Medicare enrollment in order to be approved for the submission of Medicare claims.
The NPI is a required data element on the CMS 855 Medicare enrollment forms. Required NPI fields cannot be left blank, and "pending" is not an acceptable entry in these fields.
Page Last Updated: Monday, 21-Jul-2008 10:58:20 CDT
