National Provider ID
HIPAA national provider ID number available online
By: CDA Update Staff
Federal regulations stemming from the Health Insurance Portability and Accountability Act of 1996, known as HIPAA, require all covered entities such as insurers, health plans, clearinghouses, and health care providers who transfer patient information to payers electronically, to utilize unique identifiers for health care providers.
The national provider identifier standard rule, which went into effect on May 23, 2005, and has a final compliance date of May 23, 2007, is part of the intent of HIPAA to standardize and simplify health care administration by replacing a myriad of provider ID numbers used by separate payers with a single provider ID number that will be used by all payers. The standard national provider identifier rule, or NPI, will ensure that one unique identifier number will be assigned to each provider and will be used in transactions with all health plans and insurers. The HIPAA rule requires that national provider identifiers be used by all regulated providers and be accepted by all clearinghouses and health plans in connection with the electronic transactions that HIPAA governs.
Providers regulated by HIPAA will receive their unique identifier number by applying to the U.S. Department of Health and Human Services. To facilitate the application and assignment of this national provider identifier number, HHS has created the National Plan and Provider Enumeration System to process applications and assign numbers to health care providers, and has established a website -- https://nppes.cms.hhs.gov/NPPES/Welcome.do -- to allow providers to apply online. The application process requires basic identification information and can be completed within a few minutes.
For more information
The National Plan and Provider Enumeration System website can be found at https://nppes.cms.hhs.gov/NPPES/Welcome.do. Dentists who have
questions about the national provider identification number and requirement may
contact the National Plan and Provider Enumeration System by phone at (800)
465-3203, by email at customerservice@npienumerator.com,
or by mail at NPI Enumerator, P.O. Box 6059, Fargo, ND 58108-6059.
For additional information on this or other HIPAA-related issues, contact Greg Alterton, CDA policy analyst, at (800) 736-7071, Ext. 4994.