The National Provider Identifier (NPI) is the new numeric identifier that is being assigned to physicians and other health care providers by the Centers for Medicare & Medicaid Services (CMS). It is the 10-digit permanent number assigned to you for your entire medical career.
In order for faculty to bill for services ordered or referred by you, it is necessary for you to apply for and obtain an NPI. This number will be required after you enter private practice, as it will be used to bill for your services.
Apply on line at https://nppes.cms.hhs.gov. The application process can be completed in 15-20 minutes.
Although the application is pretty straight forward, this step by step guide will assist you with answering some of the questions. The area called "Taxonomy Codes" is confusing and the notes below should be helpful.
If you have questions about the NPI on line application; click on Help in the upper right hand of each page or contact the NPI Enumerator, FOX Systems, at customerservice@npienumerator.com (1-800-465-3203)
If you have questions or suggestions for improving this guide, please email the MCWAH/GME office at gme@mcw.edu.
Acronyms, Website Links and Terms
Acronym/Full Name
Comment
NPI National Provider Identifier
Unique 10-digit identification number
NPPES National Plan and Provider Enumeration System
https://nppes.cms.hhs.gov
A system developed by CMS to improve the efficiency of electronic transmission of health care information.
HIPAA
Health Care Portability and Accountability Act of 1996
Mandated the adoption of unique identifiers for health care providers and health plans.
CMS Centers for Medicare and Medicaid Services
Developed the NPPES to assign the unique identifiers.
FOX FOX Systems Inc
CMS has contracted with FOX Systems to serve as the NPI Enumerator.
Taxonomy Codes
10 character alphanumeric descriptor used to identify the current specialty of a health care provider
These codes will change during the course of a physician's career. A non licensed physician or dentists selects a taxonomy code of 390200000X.
If you accidentally use the back button on your internet browser rather than using the previous button in the NPI software, the program will close automatically and you will need to start over on the application.
Step-by-Step Process
Step#
Item
Comments/Action
1
Go to:
Comments
You are the Health Care Provider
Action
1. Select the National Provider Identifier (NPI) link
2. Click on Apply Online for an NPI
2
NPI Application Instructions
Online Help is available from each page of the application by clicking "Help" at the top right of each of the pages.
See Information Required for Individual Providers (left hand column only)
1. Read Step 2 - The information concerning the terms of the application and the penalties for falsifying information.
2. Click on Begin Application Form
3
Select NPI User ID and Password
Create a User ID and Password
*Indicates Required Field
Make note of your user ID and password since you will need these two items to update your information as it changes during your medical career. (This information is also included in the email that you will receive from NPPES when your NPI is issued.)
4
Select Entity Type
You are an individual who renders health care services.
Select Type 1
5
Provider Profile
Complete Provider Profile.
Answer "No" to the question at the bottom of the page: Is the Provider a Sole Proprietor?
6
Mailing Address
- Enter your Residency/Fellowship program address, click Next.
- You will see a "Mailing Address Standardization" message. Choose "1" to accept the standardized address.
7
Practice Location
Also use your Residency/Fellowship program address for Practice Location
- Click on Same as Mailing Address
- Again, accept the standardized
address.
8
Other Identification Numbers
- Some housestaff may have obtained Medicare, Medicaid or UPIN Provider Numbers prior to their arrival at MCWAH. If so, enter the information on this page.
- If you don't have those numbers, click Next to go on to the next page.
9
Taxonomy/License Information
This is the most complicated part of the application. Read the points listed below before proceeding with this section of the application.
· There are over 175 Taxonomy codes from which to choose.
· If there is any doubt in selecting the appropriate code, select the most general.
· You will update your Taxonomy code throughout your career if you pursue additional subspecialties.
· List of Taxonomy Codes are available at
http://www.wpc-edi.com/codes/taxonomy.
ONLY ONE TAXONOMY CODE IS REQUIRED FOR THIS APPLICATION
· If you are not licensed as a physician or dentist in the United States
· If you are licensed in any state in the US
10
Contact Person Information
· You are in the best position to answer questions that may come up in reference to your application. Therefore, use the Provider (you) as the Contact Person.
1. Click on Same as Provider.
2. Under Additional Information for the Contact Person, use your home phone number and email address.
11
Certification Statement
Read the Statement, check the box and click Submit. Your application will be processed and you will receive email notification of your NPI will be issued within 2-10 days. Print a copy of this email and retain for your files as the information will be needed throughout your medical career.