The National Provider Identifier (NPI) number is a unique, 10-digit identifier assigned to healthcare providers in the United States. The NPI number is used to identify healthcare providers, such as physicians, hospitals, and other medical facilities, in a standardized and unique way. The Centers for Medicare and Medicaid Services (CMS) assigns NPI numbers to healthcare providers who enroll in the Medicare program or who are required to do so by their state or other payers.
NPI Number Structure and Meaning
The NPI number is composed of 10 digits, with the first 9 digits being numeric and the last digit being a check digit. The check digit is used to verify the accuracy of the NPI number. The NPI number is typically formatted as XXXXXXXXXX, with no dashes or spaces. The NPI number is unique to each healthcare provider and is used to identify them in claims, billing, and other administrative transactions.
NPI Number Types
There are two types of NPI numbers: Type 1 and Type 2. Type 1 NPI numbers are assigned to individual healthcare providers, such as physicians, dentists, and other solo practitioners. Type 2 NPI numbers are assigned to organizational providers, such as hospitals, clinics, and group practices. Both types of NPI numbers are used to identify healthcare providers in a unique and standardized way.
| NPI Number Type | Description |
|---|---|
| Type 1 | Individual healthcare providers (e.g., physicians, dentists) |
| Type 2 | Organizational providers (e.g., hospitals, clinics, group practices) |
Key Points
- The NPI number is a unique, 10-digit identifier assigned to healthcare providers in the United States.
- The NPI number is used to identify healthcare providers in a standardized and unique way.
- There are two types of NPI numbers: Type 1 (individual providers) and Type 2 (organizational providers).
- The NPI number is not the same as the tax identification number (TIN) or the Employer Identification Number (EIN).
- The NPI number is used in claims, billing, and other administrative transactions.
NPI Number Lookup and Verification
Healthcare providers and payers can use the NPI registry to look up and verify NPI numbers. The NPI registry is a publicly available database that contains information on healthcare providers, including their NPI numbers, names, and addresses. The NPI registry can be used to verify the accuracy of NPI numbers and to ensure that healthcare providers are properly identified in claims and other administrative transactions.
NPI Number Registry
The NPI registry is maintained by the CMS and is available online. The registry contains information on over 5 million healthcare providers, including physicians, hospitals, and other medical facilities. The registry is updated regularly to ensure that the information is accurate and up-to-date.
| NPI Registry Information | Description |
|---|---|
| Provider Name | The name of the healthcare provider. |
| Provider Address | The address of the healthcare provider. |
| NPI Number | The unique, 10-digit identifier assigned to the healthcare provider. |
What is the purpose of the NPI number?
+The NPI number is used to identify healthcare providers in a standardized and unique way. It is used in claims, billing, and other administrative transactions to ensure that healthcare providers are properly identified and that payments are made accurately.
How do I look up an NPI number?
+You can look up an NPI number using the NPI registry, which is a publicly available database that contains information on healthcare providers, including their NPI numbers, names, and addresses.
What is the difference between a Type 1 and Type 2 NPI number?
+A Type 1 NPI number is assigned to individual healthcare providers, such as physicians, while a Type 2 NPI number is assigned to organizational providers, such as hospitals and group practices.
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