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All health care providers (physicians, suppliers, hospitals, and others) may get an NPI. Health care providers are individuals or organizations that render health care as defined in 45 Code of Federal Regulations (CFR) 160.103. Who Must Get an NPI?
standard for a unique health identifier for health care providers for use in the health care system and announces the adoption of the National Provider Identifier (NPI) as that standard. It also establishes the implementation specifications for obtaining and using the standard unique health identifier for health care providers. The
10 Σεπ 2024 · Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).
13 Μαΐ 2013 · The NPI Final Rule, published on January 23, 2004, established the NPI as this standard. Covered entities under HIPAA are required by regulation to use NPIs to identify health care providers in HIPAA standard transactions. Guidance on NPI Requirement for Prescribers
3 Αυγ 2020 · Guidance on National Provider Identifier (NPI) Enumeration (PDF) - clarifies the prohibition at 45 CFR § 162.412(b) that a health plan may not require a health care provider that has been assigned an NPI to obtain an additional NPI.
Recently, CMS published a final rule that requires prescribers who are not covered entities themselves to obtain an individual (Entity Type 1) National Provider Identifier (NPI) and disclose it when needed for a pharmacy claim.
Covered health care providers and all health plans and health care clearinghouses must use NPIs in their administrative and financial transactions. The Administrative Simplification provisions of HIPAA required the adoption of a standard, unique health identifier for each health care provider.