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Effective URL: https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand
Submission: On March 19 via manual from US — Scanned from DE

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Sub-Site Menu: Admin Simplification
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 * Admin Simp Overview
 * Guidance
 * Transactions
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 * Enforcement
 * Unique IDs


CMS MAIN NAVIGATION


 * NATIONAL PROVIDER IDENTIFIER STANDARD (NPI)

 * * How to Apply
   * Educational Resources
   * Enumeration Reports
   * Medicare NPI Implementation
   * Data Dissemination
   * EFI


NATIONAL PROVIDER IDENTIFIER STANDARD (NPI)




The National Provider Identifier (NPI) is a Health Insurance Portability and
Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a
unique identification number for covered health care providers. Covered health
care providers and all health plans and health care clearinghouses must use the
NPIs in the administrative and financial transactions adopted under HIPAA. The
NPI is a 10-position, intelligence-free numeric identifier (10-digit number).
This means that the numbers do not carry other information about healthcare
providers, such as the state in which they live or their medical specialty. The
NPI must be used in lieu of legacy provider identifiers in the HIPAA standards
transactions.

As outlined in the Federal Regulation, The Health Insurance Portability and
Accountability Act of 1996 (HIPAA), covered providers must also share their NPI
with other providers, health plans, clearinghouses, and any entity that may need
it for billing purposes.

More detailed information is available on the pages listed in the left hand
column of this page.


NPI FREQUENTLY ASKED QUESTIONS (FAQS)

NPI FAQs are posted on the CMS website and continue to be updated as new
information is available. To view these FAQs, see the "Related Links" section
below.


DOWNLOADS

 * NPI Final Rule (PDF)
 * Dear Provider Letter from CMS Administrator (PDF)


RELATED LINKS

 * Apply Now - National Plan and Provider Enumeration System (NPPES Website)
 * Workgroup for Electronic Data Interchange (WEDI)
 * Administrative Simplification Overview
 * NPPES FAQs

Page Last Modified:
12/01/2021 08:00 PM
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