What is NPI?
The National Provider Identifier (NPI) is a unique ten digit number for individual health care providers and provider associations, such as clinics, hospitals, schools, and community practices.
The National Provider Identifier (NPI) is an Administrative Requirement for the Health Insurance Portability and Accountability Act (HIPAA).
For covered health care facilities, an NPI is a unique identification number created to increase the quality and efficacy of electronic health information transmission.
Types of NPI
There are two types of health care providers in terms of NPIs:
Type 1 — Individual healthcare providers, including doctors, dentists, and all sole proprietors, must have Type 1 NPI. One person can have only One NPI.
Type 2- Healthcare providers, including medical associations, hospitals, nursing homes, and other health care organizations, are required to have Type 2 NPI.
Individual Providers can only have one NPI. However, Organization Providers can have multiple NPIs.
If you are an individual who is a health care provider and who is incorporated, you may need to obtain an NPI for yourself (Type 1) and an NPI for your corporation or LLC (Type 2).
You will need to start with a Type 1 NPI whether you are an individual doctor or solo practitioner. Your individual NPI is identical to your number for social security. As a particular healthcare provider, it is a personal identification number for you.
A Type 2 NPI is for large to small group practices. Many group practices that supply their patients with superbills should have a Type 2 NPI. It might be vital for your way to have a Type 2 NPI in certain situations, even though you are the only healthcare provider in your practice.
Is the NPI required for all healthcare providers?
The NPI is required for all healthcare providers covered under HIPAA. In the administrative and financial transactions implemented under HIPAA, covered healthcare providers and all insurance plans and healthcare clearinghouses must use NPIs.