How Do You Apply for an NPI?
Health care providers may apply for an NPI in one of three ways:
Option 1: Apply through a web-based application process.
Visit theNational Plan and Provider Enumeration System (NPPES) at https://nppes.cms.hhs.gov/NPPES/Welcome.do on the CMS website. Individual providers must create a username and password through the Identity & Access Management (I&A) System, and log in to NPPES using that username and password.
Option 2: Complete, sign, and mail a paper application to the NPI
Enumerator address listed on the form. For a copy of the application (Form CMS-10114, “NPI Application/Update Form”). To request a hard copy application through the NPI Enumerator, call 1-800-465-3203 or TTY 1-800-692-2326, or send an email to customerservice@npienumerator.com
Option 3: Give permission to an Electronic File Interchange Organization (EFIO) to submit application data through bulk enumeration process. For more information on this option, see below or refer to https://www.cms.gov/Regulations-and-Guidance/
Administrative-Simplification/NationalProvIdentStand/apply. html.
After you have applied, search for an NPI Registration here.
Organizations Applying for NPIs on Behalf of Employed Providers
The steps below provide guidance for organization health care providers who wish to apply for NPIs or submit updates to the NPPES on behalf of their employed health care providers.
NOTE: The process described below is NOT the process for Electronic File Interchange (EFI) for bulk enumeration. Instead, an organization that is a health care provider should follow these steps when applying for an employee’s NPI on an individual record-by-record basis.
1.Confirm Employee’s Current NPI Status
Ensure the health care providers for whom the organization will apply do not already have NPIs.
2. Verify Agreement With Health Care Provider Employees
Determine if an agreement exists between the organization health care provider and its health care provider employees that give the organization the appropriate legal authority to act on behalf of those health care providers in taking actions such as completing NPI applications and updating transactions on their behalf. You may need legal counsel to determine if an existing agreement covers these types of actions. If such an agreement exists, it may not be necessary for the organization to take the actions described in items 3–5 below.
3. Notify Health Care Provider Employees of Collected Information
Ensure the health care providers know about the information collected on the NPI Application/Update Form (CMS-10114) available at http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS10114.pdf on the CMS website. Ensure they read the “Penalties for Falsifying Information on the National Provider Identifier (NPI) Application/Update Form,” “Certification Statement,” and “Privacy Act Statement” sections of that form and agree to all relevant requirements.
4. Validate NPI Application Data
Share the NPI application data with the health care providers represented in the application to ensure complete and correct data. The same applies to updating information.
5. Retain NPI Documents
Ask the health care providers to sign a document indicating that you took the above actions, and retain those documents as proof the health care providers knew about the actions taken on their behalf.
6. Designate Contact Person for NPI Confirmation
The NPPES sends an email to the “Contact Person” entered on a health care provider’s NPI application. This email informs the Contact Person of the enumerated health care provider’s NPI, and contains some of the identifying information about the health care provider (including provider name, address, and Healthcare Provider Taxonomy Code and description).
If the organization submits an NPI application on behalf of a health care provider employee, the Contact Person designated by the organization receives the NPI notification email from the NPPES. The Contact Person must forward that NPI notification (or a copy) to the health care provider employee. This notification confirms that the
NPPES assigned the health care provider employee an NPI and contains the NPI.
Organizational health care providers may feel it appropriate to have their legal counsel review this process.
Electronic File Interchange (EFI)
EFI is an alternative process for health care providers applying for an NPI. Each EFIO can submit NPI application information for hundreds or even thousands of health care providers all at one time in a single electronic file or in a series of electronic files.
EFI benefits both the health care providers and CMS. By allowing an EFIO to apply on its behalf, a health care provider itself does not have to apply for an NPI. This saves the health care provider time and resources. CMS benefits by saving the time and resources it would have expended if the NPI Enumerator (contractor that processes NPI applications) and the webbased system had to process NPI applications one at a time.
In addition to obtaining NPIs for health care providers, some EFIOs may also send changes or updates to the NPPES on behalf of enumerated health care providers to keep the providers’ NPPES records current. To send changes or updates the EFIO needs to get the permission of the health care providers. Whether or not to furnish changes or updates to a health care provider’s NPPES record is a decision made between an EFIO and its associated health care providers.