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Psychiatric Practice & Managed Care
Published Online: 17 June 2005

Apply Now for National Provider Identifier Number

Publication: Psychiatric News
Volume 40, Number 12
https://doi.org/10.1176/pn.40.12.00400013d
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The National Provider Identifier (NPI) has finally arrived after more than a decade of discussion and planning. Since May 23 health care providers have been able to apply for this new 10-digit number, which will eventually replace all current health care provider identification numbers, including the Uniform Provider Identification Number (UPIN) used by Medicare.
The creation of the NPI was mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) with the goal of improving the efficiency and effectiveness of the electronic transmission of health information.
The NPI must be used by most HIPAA-covered entities. A health care provider is a covered entity if the provider submits or receives transactions electronically that are covered under HIPAA's Electronic Transactions Standards.
Medicare, Medicaid, large private health insurers, and health care clearinghouses must start using the NPI in all their transactions with providers on May 23, 2007. Small health plans have a year longer to comply—May 23, 2008.
APA members who are not covered entities under HIPAA may want to apply for an NPI anyway, since it will eventually become the universal identifier for all U.S. health care providers and will be used in the National Provider System, which will include data on all U.S. health care providers.
You can apply for an NPI in three ways:
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Complete the online application form accessible at<https://nppes.cms.hhs.gov>.
•
Fill out a paper application and submit it to the Enumerator, the entity that will be assigning the NPIs. Applications can be downloaded from<https://nppes.cms.hhs.gov> or obtained by calling (800) 465-3203.
•
Starting in the fall, with your permission, an organization with which you are associated will be able to submit your application electronically.
In a letter sent last month to health care providers, CMS Administrator Mark B. McClellan, M.D., Ph.D., reminded providers not to begin using their NPI until they receive specific instructions from health plans about when they will start using them.
McClellan's letter is posted online at<www.cms.hhs.gov/hipaa/hipaa2/npi_provider.asp>. More information about the NPI and HIPAA is posted at<www.cms.hhs.gov/hipaa/hipaa2/regulations/identifiers/default.asp>.▪

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Psychiatric News
Volume 40 • Number 12 • June 17, 2005
Pages: 13

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Published online: 17 June 2005
Published in print: June 17, 2005

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