National Provider Identification
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard.
The National Provider Identifier (NPI) is an administrative standard under the Health Insurance Portability and Accountability Act (HIPAA) implemented to provide unique identification numbers to health care providers.
The NPI was introduced to enhance efficiency in the healthcare system of the United States. This 10-digit numeric identifier is void of any intelligence, meaning it doesn't contain intrinsic information about the healthcare provider like geographical location or specialty. Its primary purpose is to simplify the administrative and financial aspects of healthcare transactions under the purview of HIPAA.
The core essence of the NPI is to provide a unique identification number to covered health care providers, ensuring there is no ambiguity in identifying a provider in any healthcare transaction.
Use of NPI
With the implementation of the NPI, covered health care providers, as well as all health plans and health care clearinghouses, are mandated to use NPIs in all HIPAA-related administrative and financial transactions.
- The NPI stands distinct with its 10-digit format, which is entirely devoid of intelligence.
- This signifies that the NPI does not embed details such as the provider's state of operation or medical specialty.
- Legacy provider identifiers are to be replaced by the NPI in all HIPAA standard transactions.
The mandate for the use of the NPI is rooted in the Federal Regulation. As prescribed by The Health Insurance Portability and Accountability Act of 1996 (HIPAA), all covered providers are obligated to disseminate their NPI to other stakeholders, including other providers, health plans, clearinghouses, and entities involved in billing.
Use of NPI on WikiMD
In its endeavor to uniquely identify healthcare providers, WikiMD leverages the NPI by appending it post the full name and degree of the provider. This practice is notably evident in the physician directory on WikiMD.
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Contributors: Prab R. Tumpati, MD