NPI is a 10 digit unique identification number issued to health care providers in the USA by the Centers for Medicare and Medicaid Services (CMS). The NPI replaces health care provider identifiers that were used earlier. For example, the NPI replaced Medicare legacy numbers like UPINs (unique physician [provided] identification numbers) and PINs (personal identification numbers). The NPI is a 10 digit unique intelligence-free numeric identifier which means it does not carry other information about healthcare providers, such as the state in which they live or their medical specialty.
Types of NPI
There are two types of NPI and the CMS (Centers for Medicare and Medicaid Services) describes them as follow:-
Individual healthcare providers, including doctors, dentists, and all sole proprietors are the ones who need to have Type 1 NPI. A sole practitioner receives only one Type I NPI. An individual is eligible for only one NPI.
HIPAA covered entities and organizations such as hospitals, physician groups, nursing homes, and the corporation formed when an individual incorporates him/herself into a group practice are required to have Type 2 NPI.
Is my NPI Number public?
Yes, it is public as anyone with your NPI can look you up on several websites.
Why do you need an NPI Number?
Since it is mandated by HIPAA you must have an NPI if you are a HIPAA-covered health care provider or entity. There are several benefits that it offers such as:-
1. You can use it as an identifier on prescriptions, although your NPI is NOT your license number.
2. If you have an NPI number then your EMR system can easily identify you and the patient records you worked on with.
3. To keep a record of any unlawful activity as a health care practitioner.
4. The NPI is a single identification number of the provider that will be accepted and acknowledged by all health plans, thus removing the need for multiple provider identification numbers to be registered, maintained, and monitored.
What is the purpose of NPI?
It is meant to increase the health care system’s efficacy and help to minimize fraud and abuse.