General Information
NIA-Specific NPI Information
Applying for NPIs and Submitting NPIs to NIA
Organization and Subpart Information
Q: What is "NPI"?
A: The National Provider Identifier (NPI) is a 10-digit identifier required on all HIPAA-standard electronic transactions. NPIs have replaced all separately issued identifiers, including Medicaid PINs and Medicare UPINs, on HIPAA-standard electronic transactions. In the past, health plans assigned an identifying number to each provider with whom they conducted electronic business. Since providers typically work with several health plans, they were likely to have a different identification number for each plan. The NPI has been put in place so that each provider has one unique, government-issued identifier to be used in transactions with all health plans with which the provider conducts business.
Q: Is the NPI required for all health care providers?
A: Yes, NIA expects all providers submitting claims electronically to obtain and use an NPI. The NPI is required for all health care providers covered under HIPAA, including but not limited to NIA facilities and individual practitioners.
Q: Does my NPI replace my Taxpayer Identification Number (TIN)?
A: No, your NPI does not replace your TIN. TINs continue to be required on all claims - paper and electronic. The NPI is for identification purposes, while the TIN is for tax purposes. Important - claims that do not include a TIN will be rejected.
Q: How do I find out more about the NPI?
A: You can find more about the NPI by visiting the Centers for Medicare & Medicaid Services (CMS) Web site. This site includes the NPI Final Rule and an announcement letter to providers.
Q: As of May 23, 2008, does NIA require NPIs on all HIPAA standard electronic transactions?
A: Yes. While NIA fully expected providers to meet the original May 23, 2007 compliance date, we have been temporarily allowing HIPAA-standard electronic transactions to be submitted without NPIs. But, effective May 23, 2008, we require the NPI on those electronic transactions.
Q: Where can I find more information about CMS guidance on compliance with the HIPAA NPI Rule?
A: For more information, visit the following CMS Web page:
http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPI_Contingency.pdf
To view frequently asked questions about CMS Contingency Guidance:
Applying for NPIs and Submitting NPIs to NIA
Q: How do I apply for my NPI?
A: If you have not yet applied for an NPI, you should do so as soon as possible in one of three ways:
By phone: 1-800-465-3203 or TTY 1-800-692-2326
By e-mail: customerservice@npienumerator.com
By mail:
NPI Enumerator
P.O. Box 6059
Fargo, ND 58108-6059
Q: How do I submit my NPI to NIA?
A: You can also submit your NPI by mail or fax by sending us a copy of your NPI notification letter or the e-mail from NPPES:
National Imaging Associates
Attn: Data Management
14100 Magellan Plaza
Maryland Heights, MO 63043
Fax number: 314-387-5584
Q: What if I no longer have a copy of my NPI notification letter or e-mail?
A: You can log in to the NPI Enumerator page and print a copy of your NPI notification e-mail from NPPES, or you can contact the NPI Enumerator to request a copy of your NPI notification letter or e-mail.
By phone: 1-800-465-3203 or TTY 1-800-692-2326
By e-mail: customerservice@npienumerator.com
By mail:
NPI Enumerator
P.O. Box 6059
Fargo, ND 58108-6059
Q: If an Electronic File Interchange (EFI) organization obtained my NPI for me, how do I obtain a copy of the NPI notification?
A: You should contact the EFI organization that obtained the NPI for you.
Q: Is NIA now accepting the NPI on HIPAA-standard electronic transactions?
A: Yes, NIA has been accepting NPIs on HIPAA-standard electronic transactions since October 2006.
Q: Is NIA accepting NPIs on paper claim forms (CMS-1500 and UB-04 forms)?
A: Yes, NIA accepts NPIs on both the CMS-1500 (version 08/05) and the UB-04 forms. If you submit on paper claims, we encourage you to submit your NPI on paper claims.
Q: Where are the main NPI (Type 2) and rendering NPIs (Type 1) to be inserted on electronic transactions and on the paper claims forms?
A:
Q: What is a Type 1 NPI and Type 2 NPI?
A:
Organization and Subpart Information
Q: I am with an organization. Do the individual practitioners with my organization need to apply for individual (Type 1) NPIs?
A: Individual providers with organizations are not required to apply for individual (Type 1) NPIs or submit Type 1 NPIs.
Q: What is a subpart and why is a subpart enumeration necessary?
A: Health care organizations may be comprised of components that function as health care providers somewhat independently of the "parent." Subparts are the components that might conduct their own HIPAA-standard transactions, might be certified by the State separately from their "parent," or might be situated at the same location as, or a different location from, their "parent."
Q: How can an organization choose to enumerate?
A. Organizations can choose to enumerate subparts by taxonomy/specialty, TIN or site address.
Q: Does NIA prefer that organizations enumerate a certain way?
A: In order to facilitate a smoother administration in our provider and claims systems for providers/facilities that submit, or plan to submit, electronic claims:
Q: Where do I find more information about subparts?
A: