A Guide to NPIs

A National Provider Identifier (NPI) number is a unique 10-digit id assigned to healthcare providers. NPI numbers allow insurance companies to do their job efficiently. NPI numbers are free, easy to obtain, and make it much simpler for providers to help their out-of-network patients get reimbursed for medical bills.

National Provider Identifier (NPI) numbers, a guide:

What is a NPI?

A NPI is a unique 10-digit identification number – representing a distinct health care provider – for individuals and organizations alike. Having a NPI simplifies the exchange of healthcare information. A provider’s NPI is associated with information that health insurance companies use to identify and categorize the types of services they provide. This information helps insurance companies verify the provider’s information and identify their patients’ claims. It helps patients get reimbursed more quickly while reducing the likelihood of errors.

The NPI system was created to allow the full range of providers, from sole providers to hospital/medical groups, to transmit and exchange patient health information. NPI numbers are universally used by health plans in correspondence with providers, in both EHR and medical billing systems, and for claims, prescriptions, and more.

There are benefits for every provider getting a NPI number, and they’re free.

How does a NPI simplify billing?

A patient who wants to get reimbursed must file a claim and submit a coded receipt or “superbill” — from their provider — to their health insurance. If that superbill includes the provider’s NPI number, it makes it faster and easier for the patient to get paid back.

You can find more information about superbills in our guide.

NPI Information

A NPI number is associated with the following information–
Name
Gender
Enumeration Date — 
The date you were issued a NPI number.
NPI Type — 
Single Practice, Hospital, Laboratory, etc.
Status — 
Active or Inactive
Mailing Address
Practice Address
Taxonomy —
 Type of practice (e.g. doctor, therapist, acupuncturist)
License Numbers

How to get your NPI number?

NPI numbers are assigned by the Centers for Medicare & Medicaid Services as part of the National Plan and Provider Enumeration System (NPPES).

Requesting a NPI number is free and easy, just follow these steps–

Step 1:

Create an account with the Centers for Medicare & Medicaid Services:

https://nppes.cms.hhs.gov/IAWeb/warning.do?fwdurl=/register/startRegistration.do

Step 2:

Log in to the NPI website:

https://nppes.cms.hhs.gov/NPPES/Welcome.do

Step 3:

Check the box to confirm you are a healthcare provider, enter your information in the subsequent pages, and submit an application:

https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.instructions.type1

Be sure to have the following information available to complete Step 3:
Provider Name
SSN (or ITIN if not eligible for SSN)
Provider Date of Birth
Country of Birth
State of Birth (if Country of Birth is U.S.)
Provider Gender
Mailing Address
Practice Location Address and Phone Number
Taxonomy (Provider Type)
State License Information
Contact Person Name
Contact Person Phone Number and E-mail

If you have questions or would like help with any issues, you can reach Better at provider-team@getbetter.co