How are NPI numbers assigned?

What is NPI?

NPI stands for National Provider Identifier (NPI). It is a 10 digit numerical identifier for providers of health care providers. This number is unique and is in the national scope. Health care providers and all health plans and health care clearinghouses will use the National Provider Identifier in the administrative and financial transactions specified by the Health Insurance Portability and Accountability Act of 1996.

What is the purpose of NPI?

National Provider Identifier (NPI) was introduced by the federal government to health care services with the intention of improving the efficiency of the health care system and helps to reduce fraud and abuse.

How are NPI numbers assigned?

The National Provider System (NPS) would assign NPIs based on information entered into the NPS by one or more entities known as “enumerators.” Now enumerators will perform many functions such as it will enter identifying information about a health care provider into the system, will check the data validation such as checking State license number, it will notify health care provider of its NPI, and enumerators will update information about a health care provider when notified by the health care provider.

Who will use NPIs?

The NPI must be used by health insurers, health care clearinghouses, and those health care services that perform electronic transactions defined by HIPAA.

How is my NPI determined?

In actual NPI is a random ten-digit never expiring number. This number is unique and it does not contain any specific information such as license number, address, etc. about the servicer. It is also the duty of the federal government to help providers complete the application and address issues associated with an NPI.

What are the uses of NPI?

The NPI must be used in connection with the electronic transactions identified in HIPAA. For every electronic transaction found in the HIPPA, the NPI number is used. It can also be used by health care providers in health care transactions or related communications to identify themselves or other providers.