Who is eligible for an NPI number?

If you are confused about the implementation of the new National Provider Identifier (NPI), you are not alone. Many people like you still need a lot of information about it. Today in the article we will discuss what NPI is, who is eligible for it, and why it is mandatory to have an NPI number.

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What is the NPI number?

NPI or National Provider Identifier is a 10-digit numerical identifier used to identify an individual provider or a health care entity. The national provider identifier (NPI) will identify health care providers on a national level. This implies that all organizations in the health care sector can accept NPI. The NPI must replace commonly used identifiers for health care providers. For covered health care facilities, an NPI is a unique identification number created to improve the efficiency and efficacy of electronic transmission of health information. In their administrative and financial transactions, covered health care providers, and all health plans and health care clearinghouses must use NPIs.

It is an intelligence-free 10 digit unique number that does not carry information about the health care provider such as the state in which they practice, their provider type, or their specialization.

Who is eligible for NPI?

All Individuals and Organizations who meet the definition of health care provider as described at 45 CFR 160.103 are eligible to obtain a National Provider Identifier or NPI. Any individual or organization that is HIPAA covered and provide health care services are eligible for NPI. Also, if you are a provider/supplier of health care that charges

Medicare for your services then you need an NPI.

Below we have mentioned those who need NPI:-

1.     Physicians and other practitioners

2.     Physician/practitioner groups

3.     Organizations such as hospitals

4.     Laboratories

5.     Nursing homes

6.     Dental providers

7.     Suppliers such as pharmacies and medical supply companies and

8.     Any health care provider who transmits any health information in electronic form in connection with a standard transaction

9.      Ambulance companies

10. Chiropractors

11.  Clinical Social Workers

12.  Clinical Therapists

13.  Clinics

14.  Dentists

15. Group Practices

16.   Health care clearinghouses

17.   Health care plans

18.    Home health care agencies

19.    Licensed Therapists

20.    Medical Equipment suppliers

21.    Medical Laboratories

22.    Nurses

23.    Nursing homes

24.    Opticians

25.   Optometrists

26.   Pharmacies

27.   Pharmacists

28.   Physical therapists

29.   Physicians

30.   Physician Assistants

31.   Psychologists

32.   Residential Treatment Centers