What is an NPI number?

Always your doctor’s office or hospital bills your insurance company, which transmits electronic information about your health. As a result, the federal Health Insurance Portability and Accountability Act and / or HIPAA require you to have a National Provider Identifier, or NPI, number. Healthcare providers must identify themselves with this 10-digit marker when electronically submitting information on patient conditions, diagnosis, and treatments.

When the number is used

Your provider must submit the NPI number each time they make a transaction and report HIPAA. These events include patient presentation examination and treatment – and verification of insurance benefit applications, patient referrals, and pre-approval or pre-certification of services.

Required Users

In addition to doctors, dentists, pharmacists, nurses, chiropractors, physical therapists, nursing homes, ambulance companies, and medical device providers are among the providers who must carry an NPI number. Those who provide services, such as non-emergency ambulance transportation, cleaning, and installing lanes or ramps to accommodate people with disabilities, are not considered health care providers and do not receive an NPI number.

Doctor or number lookup

The National Plan Provider Enumeration System maintains a database for you to find the NPI number of a provider or the identity of the provider. The NPI registry will give you, in addition to the NPI, the provider’s address, type of service or general area of ​​practice, and the insurers accepted by the provider.