Medical Staff Pulse is
a Publication of the Chief of Staff
National Provider Identifier Reminder

Compliance Date for National Provider Identifier is May 23

Beginning May 23, healthcare providers must use a National Provider Identifier (NPI) when conducting standard electronic transactions.

Due to possible delays in acquiring the NPI as the deadline approaches, physicians are urged to submit their application by APRIL 10 to ensure their identifier is processed in time to meet this deadline.

When applying for your NPI, the Centers for Medicare & Medicaid Services recommends that physicians include their legacy identifiers for all payors, not just Medicare. If reporting a Medicaid number, include the associated state name.

This identifier implements a HIPAA requirement and must be used by most HIPAA-covered entities, which includes health plans, healthcare clearinghouses and healthcare providers that conduct electronic transactions. The NPI replaces healthcare provider identifiers in use today in standard transactions. It also eliminates the need for providers to use different identification numbers to identify themselves when conducting standard transactions with multiple health plans.

Most health plans, including Medicare, Medicaid, private insurers and all healthcare clearinghouses, must use NPIs in standard transactions by May 23, 2007. Small health plans have until May 23, 2008. After these compliance dates, physicians and other healthcare providers will be required to use their NPIs to identify themselves in standard transactions.

Once enumerated, a provider's NPI will not change and remains with the provider regardless of job or location changes.

To obtain an NPI, applications can be completed online at: https://nppes.cms.hhs.gov. You can also obtain a written application by calling 1-800-465-3203.