OCFS and NPI Issue



4/18/06

What is the purpose of the NPI? Who must use it, and when?   Document 2623

Is a health care provider required to obtain a National Provider Identifier (NPI)? Document 2622


CMS relaxes its insistence on provider ID adoption


cms Guidance on Compliance


The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers for health care providers, as well as the adoption of standard unique identifiers for health plans. The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information. The Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign these unique identifiers.
 
If you are a Health Care Provider, the National Provider Identifier (NPI) is your standard unique identifier.
 
If you are a covered Health Plan, the National Health Plan Identifier (NPlanID) is your standard unique identifier.
 
About NPPES....
CMS has contracted with Fox Systems, Inc. to serve as the NPI Enumerator.
The NPI Enumerator is responsible for dealing with health plans and providers on issues relating to unique identification.
The NPI Enumerator may be contacted as follows:
By phone:
-800-465-3203 (NPI Toll-Free)