An NPI (National Provider Identifier) number is a 10-digit numerical identifier used by health plans to identify providers for billing and claims purposes
. It is a unique identification number for covered healthcare providers, created to help send health information electronically more quickly and effectively
. NPIs are assigned by the National Provider Identifier Program (NPIP) and are used in HIPAA standard transactions
. Key points about NPI numbers include:
- Usage : Covered healthcare providers, health plans, and healthcare clearinghouses must use NPIs in their administrative and financial transactions
- Purpose : The NPI is used to replace previous identification numbers that providers used for healthcare information, such as transactions and billing
- Format : NPIs are 10-digit, intelligence-free numeric identifiers, meaning they do not carry other information about healthcare providers, such as state of residence or medical specialty
- Type : There are two types of NPI numbers: Type 1 NPIs are assigned to individual providers, while Type 2 NPIs are assigned to organizational providers
- Mandatory : The NPI is mandatory for HIPAA transactions and must be used in lieu of legacy provider identifiers
- Unique : NPIs are unique and do not change even if a provider's personal information changes
- No Replacement : The NPI does not replace other identification numbers used for other purposes, such as a provider's tax identification number, DEA registration, license number, or Social Security number
To obtain an NPI number, healthcare providers can register through the NPPES NPI Registry
