Ophthalmology & Visual Sciences
Graduate Medical Education

National Provider Identifier (NPI) Step-by-Step Guide

In accordance with the NPPES Data Dissemination Notice (CMS-6060), published May 30, 2007, certain information that you furnish will be publicly disclosed.

The National Provider Identifier (NPI) is the numeric identifier that is 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 online. 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 online application; click on Help in the upper right hand of each page or contact the NPI Enumerator, FOX Systems, at customerservice@npienumerator.com or 1 (800) 465-3203

 

Acronyms, Website Links and Terms

NPI - National Provider Identifier
Unique 10-digit identification number.

NPPES - National Plan and Provider Enumeration System
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.

I&A - Identity & Access System
This recent update streamlines access when it comes to managing your information in NPPES, PECOS, and HITECH.

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 dentist selects a taxonomy code of 390200000X- Student in an Organized Health Care Education/Training Program.

Step-by-Step Process

Step-by-Step Process

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.

Steps and Item

Comments/Action

1. Go to NPI Welcome page.

Look under "Individual Providers:"

Action

1. Click on "Create a Login". You will be re-directed to a CMS I&A page. Create a login through the Identity & Access Management System.

PRINT THE PAGE WITH YOUR USERNAME AND PASSWORDFOR YOUR RECORDS.

You will need your user ID and password 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.)

2. When completed you will be returned to the original NPPES page. Login to NPPES under "Manage or Apply for your personal NPI Record" with your I&A Username and password.

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.

1. Click on "NEW NPI Application"

2. Read Terms.

3. Click on "Submit New NPI Application"

3. Provider Profile

1. Complete Provider Profile.

*Indicates Required Field

2. Answer "No" to the question at the bottom of the page: "Is the Provider a Sole Proprietor?".

4. Business Mailing Address

1. Enter your Residency/Fellowship program address * DO NOT USE YOUR PERSONAL ADDRESS

5. Business Practice Location

1. Click on "Same As Business Mailing Address Address".

2.Enter program phone number * DO NOT USE YOUR PERSONAL PHONE NUMBER. Do not list a fax#; it is not required.  

6. Business Mailing Address Standardization

1. Click on "Accept Standardized Address".

7. Other Identification Numbers

1. 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.

2. If you don't have those numbers, click "Next" to go on to the next page.

8. Taxonomy/License Information

 

Comments

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.

 

ONLY ONE TAXONOMY CODE IS REQUIRED FOR THIS APPLICATION

If you are not licensed as a physician or dentist in the United States:

  1. Click on "Add Taxonomy".
  2. Select Provider Type Code 39 for "Student, Health Care"
  3. For Classification Name-Area of Specialization Select: Highlight "39020000X-Student in an Organized Health Care Education/Training Program".li>
  4. Your Taxonomy Code is 390200000X.
  5. Click on "Save".

If you are licensed in any state in the United States:

  1. Click on Add Taxonomy
  2. Select Provider Type Code 20 (allopathic & Osteopathic Physicians). Licensed Dentists - select code Type 12.
  3. Select the Taxonomy Code corresponding to the residency or fellowship program in which you are currently enrolled.
  4. Enter the license numbers and states where you are licensed. You will probably use the same Taxonomy code for all of the license entries.
  5. Click on "Save".

9. Contact Person Information

Comments

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.

 

Action

1. Click on Same as Provider.

2. Under Additional Information for the Contact Person, use your home phone number and email address.

10. Certification Statement

Action

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.