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The Brody School of Medicine Office of Compliance
Compliance Wise-Fall 2007


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National Provider Identifier (NPI):  Important Facts About NPI

 

  • Adopted as part of the Health Insurance Portability and Accountability of Act of 1996 to assign a standard, unique identifier for health care providers.


  • NPI is a 10 digit character that does not include personal identifying information such as specialty designation, state of employment or any other personal identifiers.


  • NPI will replace other assigned provider identifiers such as the UPIN, PIN or any other provider identification numbers that may have been assigned by an insurance plan.


  • A provider’s NPI is permanently assigned and will never change regardless of job or location changes.


  • An NPI is used to report the provider of service on a health claim form as well as the referring or ordering provider for certain services such as diagnostic tests or consultations.


  • NPI numbers are federally mandated to be shared between provider organizations that have a need to report a provider’s NPI on health claim forms. Examples of such provider organizations include diagnostic testing facilities or physician practices that accept referrals from physicians outside of their respective groups.


  • Full implementation with respect to reporting an NPI on all health insurance claim forms is expected by May 23, 2008.


  • Any Brody School of Medicine clinical staff or employees who may be contacted by outside organizations requesting a Brody provider NPI are asked to direct those requests to the Managed Care Department of Clinical Financial Services.