What is an NPI?
A National Provider Identity (NPI) is a 10-digit numerical identifier for healthcare providers. It has a countrywide scope and is specific to the provider. Previously, a provider had a unique identification number for each payer; however, beginning May 23, 2007, providers now have a single identifier that will be used by all payers.
The number is not a “smart” number, in the sense that it lacks intellect (e.g., a phone number is intelligent because starting with area code provides some indication of location).
Further, NPIs are of two types. Type 1 and Type 2 NPI. NPI type 1 is for the individual practitioner (e.g., Nurse Practitioners and Physicians’ Assistants will have their NPI.) and NPI type 2 is for group practitioners(e.g institutions such as hospitals, laboratories, and nursing homes, etc.)
When do I need a group NPI and an individual NPI?
If you’re a solo practitioner or individual doctor, you’ll need to start with a Type 1 NPI. Your NPI functions similarly to your social security number. It’s a unique identification number for you as a healthcare practitioner.
A Type 2 NPI is for large to small group practices. A Type 2 NPI should be used by most group practices that provide superbills to their patients.
Under certain circumstances, a group could have more than one NPI if it chooses. For example, a group with multiple offices or a lab may choose to get a separate Type 2 NPI for each office or ancillary
What is the purpose of NPI?
The NPI is a unique identifying number that the federal government will assign to healthcare professionals. Its goal is to boost the healthcare system’s efficiency while also reducing fraud and abuse.