Health & Wellness

What are NPI Numbers? And Why Are They Important?

The National Provider Identifier (NPI) number was created by the Centers for Medicare and Medicaid Services (CMS) to provide transparency between healthcare professionals and the healthcare system.

But what does that mean? Is it something you should care about? The NPI number is incredibly important, and knowing about it can save your practice time and money, it helps protect your patient’s privacy and protects your practice from lawsuits.

Continue reading below to learn everything you need to know about these numbers and advice on getting your own.

What Are NPI Numbers?

The NPI number is a unique 10-digit identification number given to every person in the United States. It’s also known as an SSN or Social Security Number.

This number can be used by banks, insurance companies, government agencies, and other institutions to track and identify you.

How to Get an NPI Number?

You may already have an NPI number from work; if not, use the National Plan and Provider Enumeration System to apply.

Through the Identity and Access Management System, they will request basic information, including your username and password, and generate your NPI number. Additionally, providers can apply for an NPI number on the paper or through a third party. You’ll find comprehensive instructions on the CMS website.

Benefits of Having NPI Number

Every person needs to know about their NPI number because it contains sensitive personal information. Here are some of the benefits of NPI numbers.

Prevents Healthcare Fraud

Keeping patients safe has become more challenging, with more people stealing identities to game the system. Providers can verify patient identity and clarify the line between legal and illegal activity with an NPI number.

Protects Privacy

In addition to protecting against fraud, a patient’s NPI number also protects their privacy. A hospital cannot share the medical record of someone else with another hospital without first verifying the individual’s identity. With this verification process, there is a way to prevent someone else from getting treatment under another person’s name.

Links Health Information

A patient with an NPI number links all their health records together so physicians can easily access them without asking for additional information or documents from previous healthcare providers.

In Conclusion: Who Needs an NPI?

NPIs are issued to healthcare providers. They require them to submit claims or carry out other HIPAA-specified transactions. Any person, group, or organization that offers medical or other health services or supplies is known as a healthcare provider. It comprises medical professionals and organizations, including hospitals, research facilities, and nursing homes.

That said, the time it takes to get an NPI depends on several variables: an application was submitted electronically or on paper, whether it was complete and passed all edits, and the number of applications being processed at a given moment.

A provider who submits a complete electronic application could get an NPI in as little as ten days, while it takes roughly 20 business days to process a paper application.


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