NPI Number – Do I Need One and Where Do I Get It?

There is a lot of talk out there in the medical community about NPI numbers. But what is an NPI number? An NPI number or National Provider Identifier Number is a unique identification number for health care providers which will be used by all health plans.

It is all a part of the HIPAA Act of 1996. HIPAA mandates that a standard unique health identifier for health care providers be adopted by May 23, 2007 for use with major health plans. Some smaller providers have until May 23, 2008 to obtain an NPI number. The Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign these unique identifiers.

It is not difficult to obtain an NPI number. One can be obtained by completing an application over the web. The application is fairly simple and only takes about 20 minutes. After the application is completed, the NPI number will be emailed to the provider. Sometimes they are emailed within 24 hours and sometimes it takes up to 14 days.

If you do not have internet access, or you just prefer not to complete the application over the web, you can complete a paper copy of the application and mail it in. Obviously this method will take longer for your number to be assigned.

If you are a healthcare provider in need of an NPI your billing manager should be able to apply for you. I am the owner of a billing service and we are applying for NPI numbers for all 50 plus of our providers. We consider that part of our service.

There is a little personal information that is needed about the provider in order to complete the application. For example, they require the provider’s ss#, date of birth, and city, state of birth. The rest of the information required is mostly regarding the provider’s practice.

I would advise you not to wait until the last minute to do your application. The closer it gets to the deadline of May 23, 2007, the more jammed up the system will be with applications. It is really not that big of a deal, so go ahead and get the application done early!