NPI Numbers Explained

This page talks about NPI numbers.

An NPI (National Provider Identifier) number is a 10-digit unique identification number issued by the Centers for Medicare and Medicaid Services (CMS) to US health care providers (nurses, physicians, physician assistants, physical therapists, dentists, psychiatrists, counselors, pediatricians, social workers, etc.)

The NPI replaced the UPIN (Unique Provider Identification Number) which was used in the past.

Without the NPI number, health care providers cannot be paid by their insurance companies.

Also, health care providers cannot refer their patients to other practitioners who are in the insurance system, without a valid NPI number.

More than that, all HIPAA (Health Insurance Portability and Accountability Act) business and services require the NPI. Once assigned, the NPI number is permanent.

There is minimal information required in order to obtain a NPI number. This information includes the Social Security number, date of birth, city and state, license number and country of birth.

A valid NPI number consists of 10 digits where the first 9 numbers are the identifier and the last position is a check digit, to prevent errors.

In order to obtain a valid NPI number, the health care provider must apply online through the National Plan and Provider Enumeration System (NPPES) on the Centers for Medicare and Medicaid Services (CMS) website.

The registration process is almost instantaneous. There is also available an online national registry for all NPI numbers, which began in September, 2007.

It is important to note that the NPI does not replace the tax identification number (TIN) or the provider's social security number.

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