What is an NPI number?
National Provider Identifier or NPI is a unique 10 digit number that will identify health care providers on a national level. This means that the NPI will be recognized by all entities in the health care industry. To prevent fraud and abuse, NPI was introduced to ensure consistency and effectiveness in the health care system when it comes to transmitting health information electronically. NPIs that define an individual is known as Entity Type 1 (Individual) NPIs, for example, solo practice doctor. NPIs that define entities (organizations) are known as Entity Type 2 (Organization) NPIs, such as hospitals, group practices, and specialist companies.
NPIs achieved functionality in October 2006, when the Centers of Medicare and Medicaid Services (CMS) began issuing them to each healthcare provider.
The NPI Registry
It is free of charge and reasonably easy to apply for an NPI. You simply have to visit the website of the National Plan and Provider Enumeration System. It only takes about 1 to 5 business days to get NPI via email if you provide a valid application. Sometimes you may receive your NPI email in your spam folder so please check your email frequently to ensure you receive the message.
It will only take 20 to 30 minutes to apply online once you have assembled the required documents such as your social security number and state license information.
Why NPI Matters?
HIPAA act of 1996 made it mandatory to create a unique health identifier for each health care provider to facilitate electronic transactions in health care. NPI simplifies the procedures and reduces the logistical burden on health care providers by providing a national standard for electronic health care transactions.
The NPI is important because it is made mandatory by HIPAA standards and it also simplifies administrative and financial transactions. It is a single provider unique identification number that should be accepted by all health plans, thus it removes the need to report, maintain, and track multiple provider identification numbers.
Note: – It is not compulsory to apply for an NPI for health care providers that are not “covered entities” under HIPAA.