The NPI is an Administrative Standard under the Health Insurance Portability and Accountability Act (HIPAA).
An NPI is a unique identifier for covered health care providers that was established to improve the efficiency and efficacy of electronic health information transmission.
NPIs must be used in administrative and financial transactions by covered health care providers, all health plans, and health care clearinghouses.
Who gets a National Provider Identifier (NPI)?
NPIs will be assigned to health care providers who require them to submit claims or carry out other HIPAA-mandated transactions.
An individual, group, or institution that offers medical or other health services or supplies is referred to as a “health care provider.”
This includes the following:
- physicians and other practitioners
- physician/practitioner groups
- institutions such as hospitals
- laboratories
- nursing homes
- dental providers
- pharmacies and medical supply companies
- Health care clearinghouses
- Health care plans
- Home health care agencies (HHA’s)
- Hospitals
- Licensed Therapists
- Medical Equipment suppliers
- Medical Laboratories
- Nurses
- Nursing homes
- Opticians
- Optometrists
- Pharmacies
- Pharmacists
- Physical therapists
- Physicians
- Physician Assistants
- Psychologists
- Residential Treatment Centers
What is the purpose of NPI?
The NPI is a unique identifying number that the federal government will assign to healthcare professionals. Its goal is to boost the healthcare system’s efficiency while also reducing fraud and abuse.
The NPI number is required for every HIPPA-compliant electronic transaction. Healthcare practitioners may also use it to identify themselves or other providers in healthcare transactions or correspondence.
Benefits of an NPI
HIPAA standard transactions can be easily transmitted electronically.
For health care providers, health care plans, and employers, standard unique health identifiers are required.
Efficient coordination of benefit transactions.