National Provider Identifier
National Provider Identifier (NPI)
The National Provider Identifier (NPI) is a unique identification number for covered health care providers in the United States. It is issued by the Centers for Medicare and Medicaid Services (CMS) and is used by the healthcare industry to identify providers in standard transactions, such as insurance claims.
Pronunciation
National Provider Identifier: /ˈnæʃənəl prəˈvaɪdər ˌaɪdɛntɪˈfaɪər/
Etymology
The term "National Provider Identifier" is derived from its function. It is a national-level identifier for providers of healthcare services.
Related Terms
- Healthcare Provider: A person or organization that provides medical services.
- Centers for Medicare and Medicaid Services (CMS): The federal agency that administers the nation’s major healthcare programs.
- Health Insurance Portability and Accountability Act (HIPAA): The law that mandated the adoption of standard unique identifiers for healthcare providers and health plans.
- Standard Transactions: The exchange of information between two parties to carry out financial or administrative activities related to healthcare.
Usage
The NPI is a 10-digit, intelligence-free numeric identifier that does not carry information about healthcare providers, such as the state in which they live or their medical specialty. The NPI must be used in lieu of legacy provider identifiers, such as a Unique Provider Identification Number (UPIN), in HIPAA standard transactions.
Once assigned, a provider’s NPI is permanent and remains with them regardless of job or location changes.
See Also
- Healthcare Common Procedure Coding System
- International Classification of Diseases
- Medical Identification Number
External links
- Medical encyclopedia article on National Provider Identifier
- Wikipedia's article - National Provider Identifier
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