The educational resources listed on this web page are designed to increase national awareness and provider education on the NPI.
The National Provider Identifier (NPI): What You Need to Know Booklet
This booklet was created to help you become more familiar with the National Provider Identifier (NPI). The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated 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. Covered entities under HIPAA are required by regulation to use NPIs to identify health care providers in HIPAA standard transactions.
Guidance on NPI Requirement for Prescribers
CMS published a final rule that requires prescribers who are not covered entities themselves to obtain an individual (Entity Type 1) National Provider Identifier (NPI) and disclose it when needed for a pharmacy claim. This is pursuant to certain relationships prescribers have with covered organization health care providers such as hospitals and group practices. Covered organization health care providers must direct prescribers to obtain an individual NPI by May 6, 2013. This means that virtually all prescribers must now obtain an individual NPI (Entity Type 1). CMS has developed guidance on this issue; you can view the document entitled "NPI Requirement for Prescribers" in the Downloads Section below.
Guidance on NPI Disclosures by Industry Entities to Industry Entities
CMS has received numerous inquiries from health plans and other health care industry entities who want to create directories and listings containing health care providers' NPIs. Because there is no publicly-available directory of NPIs, these entities feel it is necessary to create their own, enabling users of the directories to locate NPIs that they may need in order to create HIPAA-compliant transactions. CMS has developed guidance on this issue; you can view the document entitled "NPI Disclosures by Industry Entities to Industry Entities" in the Downloads Section below.
Special CMS Communication Regarding the NPI and Medicare DME Suppliers
This communication addresses important information for Medicare DME suppliers. (See the Downloads section below.)
NPI MLN Matters Articles
See the Downloads section below to view a compilation of MLN Matters articles pertaining to various aspects of the NPI.
Transcript for 9/26/06 NPI Roundtable for All Healthcare Providers
View the transcript for the 9/26/06 NPI Roundtable for all Healthcare Providers- see "NPI Roundtable Transcript 9-26-06" in the Downloads section below.
Transcript for 4/18/07 NPI Roundtable on Contingency Guidance for all Healthcare Providers
The transcript for the NPI Roundtable on the Contingency Guidance for all Healthcare Providers is now posted as "NPI Roundtable Transcript 4-18-07" in the Downloads section below.
NPI Frequently Asked Questions
NPI FAQs are posted on the CMS website and continue to be updated as new information is available. To view these FAQs, see the "Related Links Inside CMS" section below. To find the latest FAQs, click on the arrows next to "Date Updated".
- NPI Requirement for Prescribers [PDF, 34KB]
- NPI Tip Sheet: Organizational Health Care Providers Applying for National Provider Identifiers (NPIs) for Their Health Care Provider Employees [PDF, 344KB]
- Guidance on NPI Disclosures by Industry Entities to Industry Entities [PDF, 64KB]
- Special CMS Communication Regarding the NPI and Medicare DME Suppliers [PDF, 20KB]
- NPI Related MLN Matters Articles [PDF, 78KB]
- Page last Modified: 05/13/2013 8:17 AM
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