Links

NPI Lookup

NPI is now available on the Texmed Website 

The new NPI Look-up Tool is now live on the TMA Web site. You can check it out at https://www.texmed.org/redirects.aspx?rid=32 

You will need your TMA log-information to access the NPI. There is a feature by which members can designate up to three of their staff members to access the NPI database. There is also a cool little tutorial video, which you can access from the links on the bottom of the Look-up Tool page.

The NPI is here.  The NPI is now.  Are you using it?

Recent News:

Transcript Now Available for August 2nd FFS Medicare Q&A Roundtable- Click Medicare Implementation in the column to the left side of this screen for more information.

Dissemination of Data from the National Plan and Provider Enumeration System (NPPES) to Begin September 4, 2007- Click Data Dissemination in the column to the left side of this screen for more information.

Overview

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 will 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. Beginning May 23, 2007 (May 23, 2008, for small health plans), the NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.  Covered entities may invoke contingency plans after May 23, 2007, and guidance about contingency plans may be found in the Downloads section below.

If you are a health care provider who bills for services, you probably need an NPI.  If you bill Medicare for services, you definitely need an NPI! Getting an NPI is easy. Getting an NPI is free. The first step is to get your NPI.  If you delay applying for your NPI, you risk your cash flow and that of your health care partners as well.  

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. 

More detailed information is available on the pages listed in the left hand column of this page.

Getting an NPI is free - Not Having One Can Be Costly.

NPI Frequently Asked Questions (FAQs)

NPI FAQs are posted on the CMS website and continue to be updated as new information is available.  To view these FAQs, see the "Related Links Inside CMS" section below.  To find the latest FAQs, click on the arrows next to "Date Updated".

NPI Question Resource Sheet

Many NPI questions that providers and their staff may have can be answered by the resources provided here on the CMS NPI page. The "NPI Question Resource Sheet" points to specific resources that can help answer common questions (see Downloads below)

Please note that CMS cannot respond individually to every question submitted as feedback via the website.  However, be assured that we are reviewing all questions to determine if new educational products or "Frequently Asked Questions (FAQs)" are needed or if revisions to existing products or FAQs are warranted.

Downloads
Registration Information for 8/2/2007 FFS Medicare NPI Q&A Session:  Common Billing Errors [PDF, 54K]

Guidance on Compliance with the HIPAA National Provider Identifier Rule [PDF 16KB] 

NPI Final Rule [PDF, 249KB] 

Dear Provider Letter from CMS Administrator [PDF, 125KB] 

NPI Question Resource Sheet [PDF, 32KB] 

Related Links Inside CMS
HIPAA - General Information

Apply Now - National Plan and Provider Enumeration System (NPPES)

NPI Frequently Asked Questions (FAQs)


Related Links Outside CMSExternal Linking Policy

Workgroup for Electronic Data Interchange (WEDI) NPI Outreach Initiative