National Provider Identifier...I have mine, do you have yours?

By Scott George, BC-HIS and Paula Lush

There is a new National Provider ID (NPI) that is going into effect May 23, 2007. The Federal Health and Human Services (HHS) will require a unique NPI for every provider and every healthcare company that uses standard electronic healthcare transactions. All healthcare paper or electronic claims submitted after May 23 need this number.

Even if you do not file such transactions, the NPI has many advantages over identifiers now in use:

The NPI replaces the social security number, Tax ID, or other identifiers used in standard electronic healthcare transactions.
The NPI can replace these identifiers on hard copy transactions, association CEU certifications, and many other situations where these identifiers were required.
Providers will not have to maintain multiple, arbitrary identifiers for every insurance plan, etc.
Claims, both electronic and manual, should process more efficiently.
Protects your personal information since the NPI contains no vital information regarding the provider’s name, location, specialty, patients, or qualifications.
Identifies you as a member of the hearing healthcare team.
Does not replace state-issued licenses or other association-issued identifiers.
Does not necessarily replace the social security number or Tax ID for other purposes.

To obtain your NPI number, log onto https://nppes.cms.hhs.gov/. This website will help you go through the process step by step. You will need the following information:

your professional license number for your provider NPI
or, the Tax ID for the company NPI
personal information such as: full name, social security number, address, date of birth and state of birth.
your professional taxonomy code:

From http://codelists.wpc-edi.com/mambo_taxonomy_2.asp
Examples are:

audiologist – 231H00000X
hearing instrument specialist – 237700000X
speech-language pathologist – 235Z00000X

When you have completed the questionnaire, you are assigned a request tracking number. Typically, the actual NPI arrives by email within 30 minutes. Be sure to print these out and maintain them in your permanent files.

There is a paper NPI application that can be downloaded, completed and mailed according to the instructions. Expect about 20 days for a reply.

For questions on the process, call 1.800.465.3203 and ask for a “NPI Specialist” or email questions to: customerservice@npienumerator.com.

References

ADA Egram, dated May 23, 2005, by James Bramson, DDS