The National Provider Identifier (NPI) is a Health Insurance portability and Accountability Act (HIPAA) Administrative Standard. An NPI is a unique identification number for covered health care providers, created to improve the efficiency and effectiveness of electronic transmission of health information. Covered health care providers and all health plans and health care clearinghouses must use NPIs in their administrative and financial transactions.
The Administrative Simplification provisions of HIPAA required the adoption of a standard, unique health identifier for each health care provider. The NPI Final Rule, published on January 23, 2004, established the NPI as this standard. The Centers for Medicare & Medicaid Services (CMS) developed the National Plan and Provider Enumeration System (NPPES) to assign these unique identifiers.
This booklet answers the following questions to help you become more familiar with the NPI:
- What is an NPI?
- Who may obtain an NPI?
- Who must obtain an NPI?
- Who may not obtain an NPI?
- What are the health care provider NPI categories?
- How do you apply for an NPI?
- Where can you find resources with additional information?