What is a NPI Number?

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What is a NPI Number?
NPI stands for National Provider Identifier and it is an identification number given out by the Centers for Medicare and Medicaid Services in the US to all health care professionals or providers. The NPI is composed of a unique set of 10 numbers given to healthcare providers who need this particular number in order to be reimbursed by various insurance agencies for the services they rendered.

Aside from being able to process reimbursements with insurance companies, healthcare providers also need a NPI number if they wish to refer their patients to other healthcare providers and practitioners who are also part of the insurance system. Some healthcare practitioners also need this particular number in writing drug prescriptions for patients, which is part of the requirements in pharmacies.

Those that need a NPI number include doctors, doctor assistants, nurses, physical therapists, marriage counselors, dentists, psychiatrists, chiropractors, social workers, massage therapists, midwives, and podiatrists among other professions. In terms of healthcare institutions, all member organizations of the HIPAA or Health Insurance Portability and Accountability Act should also secure their own NPI numbers. The organizations covered under HIPAA include hospitals, nursing home facilities, residential care facilities, home health care institutions, laboratory facilities, pharmacies and drug stores, medical equipment companies, and rehabilitation centers among others.

Basically, the NPI number is required for all healthcare providers to provide for easy identification in terms of insurance claims, referrals, and prescriptions. Through the NPI number, healthcare providers will be able to communicate with co-practitioners more easily which will ultimately benefit the patients. The NPI number is also very helpful in fraud investigations involving several healthcare practitioners and agencies or institutions.

To secure a NPI number, a particular healthcare provider only needs to visit the CMS website, specifically on the National Plan and Provider Enumeration System page. NPI numbers are provided almost immediately by the same website.

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