The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. 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). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
As outlined in the Federal Regulation, The Health Insurance Portability and Accountability Act of 1996 (HIPAA), covered providers must also share their NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes.
Attached you will find The National Provider Identifier (NPI) Application/Update Form (CMS-10114). You may also access the form by clicking here.
Health care providers can apply for NPIs in one of three ways:
- For the most efficient application processing and the fastest receipt of NPIs, use the web-based application process. Simply log onto the National Plan and Provider Enumeration System (NPPES) and apply on line.
- Click here for instructions on how to apply for NPI online.
- Health care providers can agree to have an Electronic File Interchange (EFI) organization (EFIO) submit application data on their behalf (i.e., through a bulk enumeration process) if an EFIO requests their permission to do so (See ‘EFI’ link on left hand column for more information regarding this process).
- Health care providers may wish to obtain a copy of the paper NPI Application/Update Form (CMS-10114) and mail the completed, signed application to the NPI Enumerator located in Fargo, ND, whereby staff at the NPI Enumerator will enter the application data into NPPES. This form is now available for download from the CMS website (see link to the form under Downloads below). Health care providers who require assistance with this form from the NPI Enumerator may contact the enumerator in any of these ways:
- Phone: 1-800-465-3203 or TTY 1-800-692-2326
- E-mail: customerservice@npienumerator.com
- Mail:
NPI Enumerator
7125 Ambassador Road Suite 100
Windsor Mill, MD 21244-2751