National Provider Identifier (NPI) - JF Part B
National Provider Identifier (NPI)
Organizations, Suppliers, Physicians, or non-Physician Practitioners who want to bill Medicare must obtain a National Provider Identifier (NPI) via National Plan and Provider Enumeration System (NPPES). NPIs are used in administrative and financial transactions. An NPI must be included on all submitted Medicare claims. Claims missing an NPI will be unprocessable.
Individuals and organizations use NPPES to apply for NPIs and to keep their NPI information up-to-date, including addresses, phone numbers, and taxonomy codes
Individual Providers: May only have single NPI, which is associated with their unique, individual information. NPI application can be completed upon NPPES login
- Create a Login through Identity & Access Management System (I&A)
- Login to NPPES with I&A Username and password
- Complete NPI application - Application completion time is approximately 20 minutes
Healthcare Provider Organizations: Must have separate Username and password for each NPI associated with organization
- Create NPPES Username and password for NPI applying for
- Complete NPI application - Application completion time is approximately 20 minutes
NPI: What You Need to Know - Learn more about sole proprietors and difference between Type 1 and Type 2 NPIs
Individual providers must obtain a Type 1 (Individual) NPI, and organizations must obtain at least one Type 2 (Organization) NPI. The number of type 2 NPIs an organization obtains is an individual business decision.
- Type 1 NPI - Physicians and non-physician practitioners
- An individual is only eligible for one Type 1 NPI
- Students, interns and residents are also eligible and must apply for an NPI
- Type 2 NPIs - Physician groups, hospitals, nursing homes, group practices, pharmacies (not all inclusive listing)
- When an individual is a sole owner, they are required to obtain a Type 2 NPI for their organization/group practice
When there are changes in information such as name, tax identification number (TIN), address, primary practice location, taxonomy code, contact person and/or authorized officials, providers must update their NPPES information and their Medicare enrollment within 30 days.
