1. How do I apply for an NPI number?
Providers may apply for an NPI online at https://nppes.cms.hhs.gov or you can call the NPI enumerator to request a paper application at 1-800-465-3203.
2. Will the Centers for Medicare & Medicaid Services (CMS) make a national database of NPI numbers available?
Yes. CMS has announced that they will eventually publish a national database of NPI numbers. In a recent memo from the AMA, state medical societies were told that the online and downloadable files will be made available the last day in June or the first day in July 2007 (30 days following publication of the notice). The files will be available at www.cms.hhs.gov/nationalprovidentstand.
3. Is there a delay in the implementation of NPI numbers?
No. Although CMS has issued notice of its NPI contingency plan, physicians are directed to obtain their NPIs before May 23, 2007, to share their NPIs with legitimate trading partners, to use the NPI on standard transactions, to test with trading partners as soon as possible, and to document their NPI compliance efforts. The CMS guidance and contingency plans that may be implemented by covered entities do not remove the requirement and expectation for health care providers to acquire an NPI. CMS says getting an NPI is easy and free.
The CMS contingency plan states, among other things, that for some period after May 23, 2007, Medicare fee-for-service (FFS) will allow continued use of legacy numbers but it also will accept transactions only with NPIs and transactions with both NPI and legacy identifiers.
Medicare will issue notice to providers when it will require an NPI.
After May 23, 2008, the legacy number will not be permitted on any inbound or outbound transaction. CMS further directs that "as early as July 1, 2007, Medicare FFS contractors may begin rejecting claims that do not contain an NPI for the primary providers." For CMS NPI updates and advisories, go to www.cms.hhs.gov/nationalprovidentstand.
Many private insurance plans and TPAs may require you to start using NPIs as their systems become ready to accept them. Therefore, you should make every effort to obtain your NPI and upgrade your computer software to be able to send NPIs on insurance claims.