What is an NPI number?

NPI or National Provider Identifier is a 10-digit numerical identifier used to identify an individual provider or a health care entity. This number is shared with all HIPAA covered entities, health providers, employers, health plans, and payers. HIPAA has made it very clear that all the covered entities all health plans, and health care clearinghouses must use NPI numbers in the administrative and financial transactions adopted under HIPAA. Although it is a unique numerical identifier, it does not carry information about a provider, for example, a state where they practice, type of provider, their specialization, etc. Here you should know that an NPI never changes once you get it. It remains the same throughout your lifetime. Even if you change your name, address, taxonomy, or any other information of yours then also the NPI does not change.

There Are Two Categories of NPI Numbers

The two types of NPI numbers are as follow

Type 1

Individual health care providers such as dentists or solo practitioners are allocated type 1 NPI and only one number will be assigned to that individual.

Type 2

Entity Type 2 NPI numbers are given to health care organizations or group health care providers. There may be a single employee or thousands of workers in these organizations. Both the company and each contractor it hires must have an NPI with Entity type 2 NPI numbers.

Why is NPI important?

There are many benefits of having NPI numbers and these are as follow:-

1.        Simple electronic transmission of HIPAA standard transactions

2.        Standard unique health identifiers for health care providers, health care plans, and employers

3.        Efficient coordination of benefit transactions

4.        We want to notify you that there are situations where an individual NPI is respectively needed by health plans to claim.

5.        This number’s sole purpose is to facilitate organization and create national standards within HIPAA transactions.

Who Can Obtain an NPI?

All HIPAA covered entities such as doctors, healthcare providers, physicians, suppliers, or hospitals that render health care services can obtain an NPI number. If a provider enrolls in Medicare, they must have an NPI.