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What is an NPI Number?
Identification numbers for healthcare providers have been around since HIPAA began requiring them back in 1996. In 2004, the NPI Final Rule specified that these would take the form of National Provider Identifier (NPI) numbers going forward. Previously, UPINs were used to identify healthcare providers.
Every NPI takes the form of a 10-digit number. Who uses NPIs? Anyone who needs to process claims or bills may access an NPI. So, that includes health insurance companies, other physicians, and so forth.
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NPI Number FAQs
Q: What types of entities have NPI numbers assigned to them?
A: Any and all healthcare providers that are HIPAA-covered have NPIs. Some examples include physicians, nurse practitioners, dentists, physical therapists, chiropractors, pharmacy technicians and so forth. The list is far more extensive than that.
Q: Who issues NPI numbers?
A: Centers for Medicare & Medicaid Services (CMS) is the entity which issues NPI numbers.
Q: Is an NPI number the same as a DEA number, or can one substitute for the other?
A: No, the purposes of the NPI number and that of the Drug Enforcement Administration (DEA) number are different from one another. That means that even if you have the DEA number for an entity, you may still need to find the NPI number.
Q: Do providers ever get new NPI numbers?
A: Generally speaking, no. An NPI number is assigned permanently, rather like an EIN. Even if the provider?s other information (i.e. name or address) changes, the NPI will remain identical.
Q: Are NPI numbers issued to students, residents and interns?
A: Yes. Even though these medical providers are still in training, they are also still healthcare providers. As such, they require NPI numbers like other healthcare providers.
Q: How do NPI numbers work when there is a parent organization with subparts providing services?
A: That depends on the individual organization and how it is structured.