The NPI (National Provider Identifier) Registry enables you to search for providers in the NPPES (National Plan and Provider Enumeration System) system.
The NPI Registry distributes all of its data in compliance with the NPPES Data Dissemination Notice. The NPI Registry is completely free to use.
What is NPI?
HIPAA mandates that covered healthcare providers in the United States have a unique ten-digit identification number.
The NPI must be used in administrative and financial activities under HIPAA by covered providers, health plans, and healthcare clearinghouses (public or commercial entities that process or assist the processing of health information).
What is the purpose of an NPI?
The only purpose of this number is to facilitate organization and develop national standards within HIPAA transactions; however, a provider’s NPI can be used to look up information from the National Plan and Provider Enumeration System (NPPES).
The NPI is an “intelligence-free” number, meaning it contains no personal information about the bearer other than a name and business address.
Although having an NPI registration information does not guarantee that a provider is certified, it is required by all certified providers.
Who must obtain an NPI?
All HIPAA-covered healthcare professionals, both individuals, and organizations must get an NPI.
Who may not obtain an NPI?
Entities that do not fit HIPAA’s definition of a healthcare provider are not eligible for an NPI.
What are the different NPI categories for healthcare providers?
For NPI enumeration, there are two types of healthcare providers:
Type 1 (individual) Individuals who provide healthcare services, such as physicians, nurses, dentists, pharmacists, and solo providers, fall within this group.
Type 2 (Organization) Hospitals and home health agencies fall within this category, as do other organizations that provide healthcare services or supplies to patients.
How to Look Up an NPI
An NPI lookup for a provider or an organization can be done in a variety of ways. The NPPES NPI registry is the official NPI lookup website. Anyone can use this service for free. You can begin with either the NPI number or a name.