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NPI Number

N P I number or National Provider Identifier number  is a unique identification number for health care providers.  All health care providers must apply for an NPI if they wish to be reimbursed by insurance companies, refer patients to others, or write prescriptions.

Who Needs An NPI #?

Yes you need an NPI# if you do any of the above (refer patients, bill insurance companies or write prescriptions) and are a
  • dentist
  • nurse practitioner
  • social worker
  • marriage counselor
  • massage therapist
  • chiropractor
  • midwife
  • podiatrist
  • or basically any other health care professional you need at least one NPI#.

Why You Need An NPI

Without an NPI# you will not be able to get paid by insurance companies.  If you refer patients to other providers who are paid by insurance companies, they need your NPI in order to get paid by insurance companies.  They must report your name and NPI# on the claim form.  Pharmacies will no longer fill perscriptions without the NPI# of the referring physician.

The Reason for NPI Numbers
Currently, many providers have several different identification numbers - one for each insurance company they bill insurance claims.  Eventually the NPI numbers should replace the need for all other identification numbers.  They will be used by all health plans.     
   HIPAA mandated that a standard unique health identifier for health care providers be adopted by May 23, 2008.  Implementation of the NPI is expected to help reduce health care fraud, transaction errors, and ultimately costs. 

When Two NP1 Numbers are Required

A second NP1 number is required when it is a group practice billing under a group name and paying taxes under an EIN number rather than a social security number.  (Even if there is only one provider right now)

Who are We and Why Get Your NP1 # From Us
Solutions Medical Billing Inc. is a medical billing service in Rome, NY. Years ago when news of the NPI# first came out we obtained NPI numbers for most of our 70 providers.  Since then we have applied for NPI numbers for hundreds of providers and can get around the application website pretty quickly so we can do it for a very reasonable price.  We can complete the application and get your NPI for you usually by tomorrow morning - sometimes today!

Frequently Asked Questions About the NP1 Number

Does my NP1 change with my job?
No it does not ever change.  Just like your social security number. 

How do I find out if I already have an NP1?
Search the registry.  It's easy. National Registry.  

What if I need someone elses number?
Look it up.  See previous question.

If I work at two locations do I need 2 NP1s?
No.  A single provider will only ever have one individual NP1.  He may also require a Type II or group number.  See "when 2 NP1 #s are required" above.

Where do I enter the NP1 number on the CMS 1500 form?
You need to read our "How to Complete the CMS 1500" book. 

Do I need an NP1 if I work for a non-profit.
Yes.  You may need to refer a patient to a for-profit provider.

What is a taxonomy code and how do I choose the right one for the NP1?
It is an administrative code to identify the provider type and area of specialization.  It is determined basically by your credentials.  We choose the proper taxonomy code for your specialty so you will be paid by insurance companies for your specialty.

Can a foreign doctor apply for an NP1?
Yes, as long as he or she has a social security number.


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