The Health Insurance Portability and
Accountability Act of 1996 (HIPAA) mandated that the Secretary of Health and
Human Services adopt a standard unique health identifier for health care
providers. On January 23, 2004, the Secretary published a Final Rule that
adopted the National Provider Identifier (NPI) as this identifier.
All HIPAA covered health care providers,
whether they are individuals or organizations, must obtain an NPI for use to
identify themselves in HIPAA-standard transactions, replacing health
care provider identifiers in use today in HIPAA standard transactions. Once
enumerated, a provider's NPI will not change. The NPI is a permanent
identifier, assigned for life, remaining with the provider regardless of job or
location changes. An NPI is a unique 10 digit identifier assigned to health
care providers and organizations. The NPI will not have any embedded
intelligence, nor will it replace the tax identification number (TIN), which is
an IRS requirement.
HIPAA covered entities such as providers
completing electronic transactions, health care clearinghouses, and large
health plans, must use only the NPI to identify covered health care providers
in standard transactions by May 23, 2007.
The application for an NPI takes approximately
20 minutes to complete. There are three ways to apply for an NPI:
Complete the application online at https://nppes.cms.hhs.gov .
- Download a paper copy at https://nppes.cms.hhs.gov .
- Call 1-800-465-3203 to request a
copy of the application.
Having an NPI will not: ensure that the
provider is licensed or credentialed; guarantee payment by a health plan;
enroll a provider in a health plan; turn a provider into a covered entity; and
require a provider to conduct HIPAA transactions.
Once you have obtained both your
practice and individual NPI, you must share this with Shawnee Mission Medical
Center's NPI delegate to ensure your billing is not affected. Please fax your NPI
number to the Medical Staff Office at 913-676-2676. If you have any questions,
please contact the Medical Staff office at 913-676-2098.
Other resources include:
4.) NPI customer service phone number, 1-800-465-3203
5.) Mailing Address:
P.O. Box 6059
Fargo, ND 58108-6059