NPI Number - Who Is Required to Have Them by May 23, 2007

Many people believe that the NPI number wasMedicare provider number, Medicaid provider
initiated by the HIPAA Act of 1996. Actually, thenumber, Champus provider number, UPIN number,
NPI number was initiated by CMS (Centers forand all other payors' unique provider numbers
Medicare & Medicaid Services) in July of 1993.(such as Blue Cross Blue Shield). NPI numbers will
CMS wanted a national identification system for allnot replace tax id number or social security
healthcare providers and many of the existingnumber, DEA number, taxonomy number, or
identifiers did not meet the standards for nationallicense number.
standards. The HIPAA Act of 1996 required theOnce an NPI number is assigned to a covered
adoption and use of a standard unique identifierhealthcare provider it will not change. NPI numbers
for healthcare providers. All covered healthcarewill travel with a healthcare provider if they move
providers will be required to have an NPI numberfrom one geographical location to another. NPI
by May 23, 2007.numbers can be deactivated if the healthcare
The National Provider Identifier, or NPI, is a 10provider is deceased or goes out of business. NPI
position, all numeric, identification number assignednumbers will not be reissued to a different
by the NPS to uniquely identify a healthcarehealthcare provider once they have been
provider. If you are an individual healthcaredeactivated.
provider you will need to apply for an NPI numberCovered healthcare providers can apply for their
under your individual name. If you belong to aNPI number from now until May 23, 2007.
medical group, you will need an NPI number forApplications began being accepted in May of 2005.
the group and an NPI number for each individualI strongly recommend that you apply immediately.
healthcare provider in the group.There is no reason to put it off. The closer it gets
Medical Billing Services are not eligible for NPIto the deadline, the busier the application process
numbers because they are not a coveredwill become.
healthcare provider. A covered healthcareAny changes in information need to be reported
provider is any provider who transmits any healthto NPPES within 30 days of the change.
information in electronic form.NPI numbers can be obtained by completing an
NPI numbers will replace the healthcare provider'sonline application which takes about 20 minutes.