A national provider identifier (NPI) is a ten-digit identification number required by HIPAA for covered healthcare providers in the United States.
Under HIPAA, covered insurers, health plans, and healthcare clearinghouses—public or commercial organisations that handle or promote health information processing—must use the NPI in administrative and financial operations.
What is the purpose of an NPI?
A national provider identifier (NPI) is a ten-digit identification number required by HIPAA for covered healthcare providers in the United States.
Under HIPAA, covered insurers, health plans, and healthcare clearinghouses—public or private organisations that handle or promote health information processing—must use the NPI in administrative and financial transactions.
Having an NPI does not guarantee that a provider is licensed, but all
licensed providers must have an NPI.
Who must obtain an NPI?
A National Provider Identifier, or NPI, is available to all individuals and organisations who fit the description of a health care provider as defined in 45 CFR 160.103.
There are two types of health care providers in terms of NPIs:-
Type 1 NPI is required for all healthcare providers, including doctors, dentists, and sole proprietors. An individual is only allowed to have one NPI.
Type 2- Hospitals and home health agencies that provide healthcare facilities or supplies to patients fall into this category.
Once assigned, a provider’s NPI is permanent and follows them everywhere they go, regardless of job or location changes.
Do Doctors have NPI numbers?
Yes, it is mandatory to have an NPI number for doctors too. All individuals covered by HIPAA, such as doctors, physician assistants, occupational therapists, pharmacy technicians, and others, as well as organizations such as hospitals, home health services, nursing homes, group practices, labs, pharmacies, medical equipment companies, and others, must obtain an NPI for use in all regular HIPAA transactions, according to the act.