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National Provider ID

The National Provider Identification (NPI) is a unique identification number for healthcare providers used to identify a healthcare provider in standard transactions, such as healthcare claims. The NPI may be used to identify healthcare providers on prescriptions, internal files to link proprietary provider identification numbers and other information, in coordination of benefits between health plans, in patient medical record systems, in program integrity files and other ways.

Any healthcare provider who submits claims or conducts other transactions specified by HIPAA must have an NPI. These include:

  • Physicians and other practitioners
  • Physician/practitioner groups
  • Institutions such as hospitals, laboratories and nursing homes
  • Organizations such as health maintenance organizations
  • Suppliers such as pharmacies and medical supply companies.

The NPI requirement does not apply to health industry workers, such as admissions and billing personnel, housekeeping staff and orderlies, who support the provision of healthcare but do not provide healthcare services.

NPI Resources

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