Validating national provider identifier


16-Jul-2017 16:15

Before we get started, let's talk briefly about the .A card issuer identifier is an identifier for an entity that issues a health care identification card.Health care providers who are not considered covered entities may also apply and be assigned an NPI.However, entities that do not provide health care (e.g., transportation services) are not eligible to be assigned NPIs because they do not meet the definition of "health care provider" and are not subject to HIPAA regulations.Legacy identification numbers (e.g., UPIN, Blue Cross and Blue Shield Numbers, CHAMPUS Number, Medicaid Number, etc.) will not be permitted.Health care providers will no longer have to keep track of multiple numbers to identify themselves in standard transactions with one or more health plans.

validating national provider identifier-74

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The form can be submitted on paper or over the Internet.

Once a health care provider has been assigned an NPI, it must furnish updates to its data within 30 days of any changes.

The National Provider System (NPS), being built under a Centers for Medicare & Medicaid Services (CMS) contract, will process the applications and updates, ensure the uniqueness of the health care provider, and generate the NPIs.

The compliance date for all covered entities is May 23, 2007, except that small health plans do not need to comply until May 23, 2008.

When the NPI is implemented, covered entities will use only the NPI to identify health care providers in all standard transactions.

The Final Rule requires covered health care providers to determine if they have subparts that may need NPIs and, if so, to obtain NPIs for the subparts or require the subparts to obtain their own NPIs.



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