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

Compliance Date for National Provider Identifier is May 23

In just about 100 days, healthcare providers such as physicians, dentists and pharmacists must use a National Provider Identifier (NPI) when conducting standard electronic transactions, even if they use billing agencies to prepare them. These transactions include claims, eligibility and claims inquiries and responses, referrals and remittance advices.

The final date established by The Centers for Medicare & Medicaid Services for compliance is May 23. Cedars-Sinai physicians are urged to submit their application by April 10 to ensure their identifier is processed in time to meet this deadline.

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 will replace healthcare provider identifiers in use today in standard transactions and 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 the compliance date, physicians and other healthcare providers may use only 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.