The National Provider Identifier is an identification number for covered healthcare providers. A unique, 10-digit number not containing personal information pertaining to the provider it belongs to, but rather as a way to assign responsibility to the provider for transactions conducted under HIPAA compliance, and identifying themselves as a healthcare provider without releasing personal information.
What an NPI is typically used for
A provider may use an NPI for a few common reasons...
- Documenting HIPAA transactions.
- Standardized way of identifying themselves as a healthcare provider.
- Health care plans
- Employers record
- Assigning responsibility when conducting HIPAA transactions (especially financial)
Who is required to have an NPI
Any HIPAA-covered entity, including...
- Healthcare providers conducting transactions electronically
- Healthcare clearing houses
- Health plans including but not limited to: Commercial plans / Medicare / Medicaid
Do I need an NPI
If you do not meet the definition of a healthcare provider as outlined in 45 CFR 160.103, you won't have an NPI or have the ability to obtain one.
For more information, please refer to the official documentation.