National Provider Identifier (NPI) frequently asked questions
- What is an NPI?
- Is a health care provider required to obtain an NPI?
- Why do health care providers need NPI numbers?
- How can health care providers obtain an NPI?
- How many NPI numbers do health care providers need?
- What is my Primary Provider Taxonomy Code?
- How long will it take to receive an NPI?
- How can health care providers report NPIs to First Choice?
- Where can I find more information about the NPI?
What is an NPI?
Is a health care provider required to obtain an NPI?
Why do health care providers need NPI numbers?
How can health care providers obtain an NPI?
Providers who have not yet obtained their NPI may apply for it in one of the following ways:
- A web-based application that takes about 20 minutes to complete online at https://nppes.cms.hhs.gov.
- A paper application that may be downloaded from https://nppes.cms.hhs.gov, or you can call the NPI Enumerator call center at 1-800-465-3203 to request a paper application.
- An electronic file submitted by an organization: you must have the healthcare provider's permission to apply for an NPI by this method.
How many NPI numbers do health care providers need?
An individual is eligible for a single NPI. An individual cannot have subparts and cannot designate subparts. In terms of NPI assignments, an individual is an Entity Type 1 (Individual).
A sole proprietor/sole proprietorship is eligible for a single NPI. A sole proprietor/sole proprietorship cannot have subparts and cannot designate subparts. In terms of NPI assignment, a sole proprietor/sole proprietorship is an Entity Type I (Individual).
Organizations must also apply for a single NPI. In terms of NPI assignment, organization healthcare providers who are covered entities under HIPAA must apply for NPIs as Entity Type 2 (Organizations).
Organization health care providers are corporations or partnerships or other types of businesses that are considered separate from an individual by the state in which they exist. Subparts of such organization health care providers who apply for NPIs are also Entity Type 2 (Organizations).
A subpart must have its own NPI if it conducts any HIPAA standard transactions separately from the covered organization healthcare provider of which it is a part. If your organization has subparts, make sure they obtain their own unique NPIs or get the NPIs for them. For further clarification about entity types and subparts, visit the Centers for Medicare and Medicaid Services (CMS) website. Select the Medicare NPI Implementation link and then the Medicare Subpart Expectations PDF.