How to Lookup NPI Numbers for Physicians
The Health Insurance Portability and Accountability Act (HIPAA) requires all doctors, hospitals, and healthcare agencies to apply for a National Provider Identifier (NPI). As an industry standard, NPI is a unique identifier used by insurers, health plans, prescribers, healthcare clearinghouses, business associates, and others to file or process health insurance claims. The National Provider Identifier (NPI) is used to describe a health care provider in routine transactions including health insurance claims. In regular transactions, HIPAA allows protected organizations to use NPIs.
And if your employer files the application for your NPI number, it is yours. When you change practices or function in different situations, the NPI remains the same. You can only have one exclusive NPI. It can be used by all eligible insurance insurers, obviating the need for the multiple provider numbers already allocated by Medicare, Medicaid, and private payers.
How do I find a NPI number?
It is very easy to find NPI. A physician, other health care provider, or organization may access NPI information through CMS’s online NPI registry (nppes.cms.hhs.gov). The NPI registry is completed on the same National Plan and Provider Enumeration System (NPPES) web site. The database is regularly updated with the latest NPI information provided by individuals and organizations.
The National Plan and Provider Enumeration System (NPPES) is where an individual or organization can apply for NPI.
What is an NPI number used for?
With the NPI, CMS is working to develop electronic transactions in health care. The adoption of a national standard for electronic health-care transactions streamlines procedures and eliminates logistical costs for health-care providers. Prior to the NPI, health care providers and vendors were given identification numbers by a health plan (federal services like Medicare, state Medicaid programs, or private health plans). Since the identification numbers were not standardized, a single provider could receive different identification numbers from the various insurance plans in which he or she was enrolled.