Acquiring NPI

National Provider Identifier (NPI) Registration

By replacing the various unique identifiers currently used by physicians when dealing with different payers, the NPI works toward fulfilling HIPAA's administrative simplification goals.  After May 23, 2008, all healthcare providers and plans will be required to use and accept only NPIs in standard transactions (small health plans will have one extra year). The compliance date was May 23, 2007 however the Centers for Medicare and Medicaid Services (CMS) extended this timeframe one year through a "contingency plan" in order to give the healthcare industry needed more time to prepare. By replacing the various unique identifiers currently used by physicians when dealing with different payers, the NPI works toward fulfilling HIPAA’s administrative simplification goals.

NPIs will be used to identify health care providers in the following standard transactions: claims, eligibly inquires and responses, claim status inquiries and responses, referrals and remittance advices. Even providers who employ third party business associates to conduct standard electronic transactions on their behalf will need to obtain an NPI.

Additional information on NPIs from CMS.
This link will take you off the AMA Web site. The AMA is not responsible for content of other Web sites.

Application for an NPI can be accomplished in three ways:
1) online application (individually, by group practice or organization. This link will take you off the AMA Web site.)
2) by requesting a paper application from the same Web site; or
3) by calling (800) 465-3203.

Group practices should decide ahead of time whether physicians will file for NPIs individually or as a group. Physicians who are unincorporated need one NPI. Incorporated physicians need an NPI for themselves and one for their group.  More information can be found on the CMS website. (This link will take you off the AMA Web site.)