HIPAA provisions require all healthcare providers who are HIPAA-covered entities to have a National Provider Identifier (NPI). This number is a unique, government-issued, standard identification number for individual healthcare providers as well as provider organizations like clinics, hospitals, pharmacies, schools, and group practices.
Your unique NPI identifier is required for the following HIPAA-standard transactions:
- Claims and encounter information
- Claims status
- Coordination of benefits and premium payment
- Eligibility, enrollment, and disenrollment
- Payment and remittance advice
- Referrals and authorizations
For more information, refer to the Transactions Overview page.
You will need an NPI number prior to submitting claims or conducting other transactions as specified by HIPAA. The 10-digit number is used by all health plans and does not expire or change.
How to apply for a National Provider Identifier (NPI)
Applying for an identifier is a free procedure that will save healthcare providers time and headaches in the future.
You can apply for your NPI one of three ways:
1. Apply through National Plan and Provider Enumeration System (NPPES)
2. Complete, sign, and mail a paper NPI Application/Update Form to
7125 Ambassador Road Ste 100
Mill, MD 21244
3. Give permission to an Electronic File Interchange Organization (EFIO) to send application data through bulk enumeration process
You can apply online, by mail, or through a designated CMS contractor. The online application is recommended, because it is generally quicker and easier to track the status.
The National Plan and Provider Enumeration System (NPPES) website contains frequently asked questions and other helpful information.
Following your application
After confirmation of your data’s receipt, you will receive your NPI via email from Customerservice@NPIEnumerator.com. If you have spam filtering on your email interface, the reply from the NPI Enumerator with your NPI and confirmation message may be intercepted and diverted to a spam folder. Be sure to check this folder regularly after submitting your data.
Receiving your NPI
The amount of time it takes to obtain an NPI is dependent upon the volume of applications being processed at a given time, whether the application was submitted electronically or on paper, and whether the application was complete and passed all edits. A provider who submits a properly completed electronic application could have an NPI in ten days. The paper application process takes approximately 20 business days.
To obtain your National Provider Identifier, go to http://nppes.cms.hhs.gov/ or call customer service at 800.465.3203.
Questions about the status of an NPI application may be emailed to customerservice@NPIEnumerator.com.
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Last updated 6/29/2022