The administration simplification provisions of HIPAA required the Secretary of Health and Human Services (HHS) to adopt a national standard identifier for covered health care providers. The National Provider Identifier (NPI) will be the standard identifier and CMS is developing the National Plan and Provider Enumeration System (NPPES) to identify providers and assign NPIs.
The NPI is ten-digit number and is used to submit claim transactions to all government and non-government payers. NPI replaced existing provider numbers assigned by these entities and CMS will discontinue the UPIN enumeration process.
Providers who are required to obtain an NPI include:
Each individual practitioner will receive one NPI. However, an organization provider may obtain an NPI for each of its subparts.
A subpart can be considered:
To complete an application, visit https://nppes.cms.hhs.gov on the Web.
For additional information about NPI, visit our NPI Resource page.
Updated 06/2009
Subpart – A component or separate physical location of an organization health care provider. Examples:
National Provider Identifier (NPI) - A system for uniquely identifying all providers of health care services, supplies, and equipment. NPIs are assigned by the NPPES and are 10-position, all-numeric identification numbers that will identify a health care provider in standard transactions, such as health care claims.
National Plan and Provider Enumeration System (NPPES) - The administrative system for supporting a national plan and provider registry. This is a comprehensive uniform system for identifying and uniquely enumerating health care providers and plans at the national level.