What is an NPI registry?
NPI registry stands for National Provider Identifier. It is a unique 10-digit identification number issued to healthcare providers by the Centers for Medicare and Medicaid Services in the United States. It is an online query system that helps users search for healthcare providers’ information.
Standard of HIPPA (Health Insurance Portability and Accountability Act)
On January 23, 2004, the final standard of the NPI rule was published. This unique identification number improves the effectiveness and efficiency of the electronic transmission of health information.
HIPPA covered entities:
HIPPA-covered individuals and organizations must get their NPI. The HIPPA-covered healthcare individuals electronically transmitting healthcare information must get their NPI.
HIPPA-covered individuals include:
- Physicians
- Physical therapists
- Psychologists
- Nurses
- Dentists
HIPPA-covered organizations include:
- Hospitals
- Clinics
- Nursing homes
- Pharmacists
Categories of NPI:
There are two categories of NPI.
- TYPE 1
- TYPE 2
Type 1: individual healthcare providers or sole proprietors
These healthcare providers get entity type 1 by using their own SSNs.
Type 2: organization healthcare providers
Organizations may have single or multiple healthcare providers. These healthcare providers are eligible for NPIs as entity type 2.
How to apply for the NPI registry?
Enrollment:
Both healthcare providers, including individuals and organizations, apply for NPI. It is an application process; you must give personal and practice-related information. You can apply through NPPES (National Plan and Provider Enumeration System).
Application approval:
Upon approval, the healthcare provider is given a unique NPI. This unique NPI number does not change even if you change your name, speciality, or location. It is permanent for a lifetime.
Including in the registry:
The next step is inclusion in the registry. Your information, such as name, speciality, and address where you practice, is included and easily accessible to everyone.
How to access the NPI registry?
The NPI registry contains information about the healthcare provider, such as their name, location of work, and speciality, and anyone can search for that information.
- NPI registry tool: it can be searched online through NPPES (National Plan and Provider Enumeration System).
- Criteria: it can also be accessed by searching criteria such as the name, speciality, or NPI number.
Benefits of NPI:
- Identifying healthcare providers: Healthcare providers with NPI can be identified and standardised around the US.
- Building trust: NPI can create trust between the healthcare providers and the public as their information is easily accessible.
- Billing and claims: It increases the efficiency of billing and claims with fewer or no errors.
Questions related to the NPI registry:
What is the purpose of the NPI registry?
It helps users get healthcare provider information that is easily accessible online.
How often NPI registry is updated?
It is updated daily. It includes information such as mailing addresses and the location of the practice.
Does the NPI number expire?
NPI number never expires and remains the same for a lifetime. It is solely yours and is never assigned to any other healthcare provider.
Does it require an SSN (Social Security Number)?
Yes! To apply for NPI, you must provide your SSN, not your EIN (Employer Identification Number).
Can you share the NPI number?
You can only share your number with people you trust. You should know why they are asking for it and what reason.
Conclusion:
The NPI registry is one of the most important parts of the healthcare system in the United States. This allows the public to access information about healthcare providers online and helps send health information more effectively. NPI helps users make informed decisions about their health, as all required information is available online.
