NPI (National Provider Identification)

NPI is required to be included in all electronic healthcare transactions as of May 23, 2007. Small health plans have an additional year.

The Stratford program, windows version, now has this code integrated throughout the software - as of Late 2004. You may go to any of the provider screens - rendering, referring, supervising, etc. and see a textbox which will accurately edit your entry. When you enter the 10 digit NPI, the software will alert you if the number is invalid.

The CMS paper claim code and the Ansi X.12 transaction sets for EDI contain the code now. This code was activated on 01/03/2006 (the first day that payers were required to receive it. The Stratford EDI format with NPI in all required segments was approved by Medicare on 01/12/2006. Stratford Software was probably the first software vendor to have the NPI approved in its EDI format.

Here is some current information as of September 2006

Scheduled National Plan and Provider Enumeration System (NPPES)

Health care providers can still, however, apply for National Provider Identifiers (NPI) in one of three ways.

1. For the most efficient application processing and the fastest receipt of NPIs, health care providers should consider using the web-based NPI application process. They can log onto the National Plan and Provider Enumeration System (NPPES) and apply on line at https://nppes.cms.hhs.gov/NPPES/Welcome.doc; or

2. Health care providers can agree to have an Electronic File Interchange (EFI) organization (EFIO) submit application data on their behalf (i.e., through a bulk enumeration process) if an EFIO requests their permission to do so; or,

3. Health care providers may wish to obtain a copy of the paper NPI Application/Update Form (CMS-10114) and mail the completed, signed application to the NPI Enumerator located in Fargo, ND, whereby staff at the NPI Enumerator will enter the application data into NPPES.

The form will be available only upon request through the NPI Enumerator. Health care providers who wish to obtain a copy of this form must contact the NPI Enumerator in any of these ways:
Phone: 1-800-465-3203 or TTY 1-800-692-2326
E-mail: customerservice@npienumerator.com
Mail: NPI Enumerator
P.O. Box 6059
Fargo, ND 58108-6059

CMS NPI Roundtable - September 26, 2006
* CMS will host a national NPI Roundtable, open to all health care professionals, on Tuesday, September 26th from 2:00-3:30PM ET.
* To participate, you may call 1-877-203-0044, pass code 4795739
CMS will address common questions related to Medicare's guidance on Subparts. While CMS will only address questions from a Medicare perspective, this information may be helpful to all providers. Getting an NPI is free - not having one can be costly.

Here is more information and links (some of it may be out of date)

Providers can get their NPI ID online by visiting this web site:

http://new.cms.hhs.gov/NationalProvIdentStand/03_apply.asp#TopOfPage

The application in PDF format is here:

http://new.cms.hhs.gov/NationalProvIdentStand/Downloads/NPIapplication.pdf

more information is here

www.cms.hhs.gov/NationalProvIdentStand/01_overview.asp

http://new.cms.hhs.gov/center/provider.asp

http://new.cms.hhs.gov/NationalProvIdentStand/01_overview.asp

http://new.cms.hhs.gov/NationalProvIdentStand/02_Regulations.asp

http://new.cms.hhs.gov/NationalProvIdentStand/Downloads/NPIFactSheet_010906.pdf (fact sheet)

For More Information Contact:

Stratford Software, Inc

Internet: support@stratfordsoftware.com

Send mail to webmaster@stratfordsoftware.com with questions or comments about this web site.
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Last modified: 03/08/17