CMS Announces NPI Dissemination Plan

The waiting game is over for family physicians and other health care providers who have been anticipating word from CMS on how it would disseminate National Provider Identifier, or NPI, information.

Highlights of the CMS plan were announced in a notice on the agency's Web site, with official notification published in the May 30 Federal Register. (PDF file: 4 pages / 64 KB. More about PDFs.)

To submit Medicare health care claims transactions that are compliant with the Health Insurance Portability and Accountability Act, or HIPAA,
physicians need access to the NPI numbers of other health care providers who were involved in the care of a patient.

According to the Federal Register notice, NPI information will be made public on June 28 -- 30 days from publication of the notice -- via a query-only Internet database searchable by NPI number or provider name. Information also will be available in a downloadable Internet file that CMS will update monthly.

In the near future, HHS will announce, via CMS' NPI Web page, the Internet locations of the downloadable files and the query-only database.

According to CMS, some data elements required on the NPI application are not disclosable to the public due to the Freedom of Information Act, so physicians and others are assured that their social security numbers, taxpayer identification numbers and dates of birth will not appear in the database.

In addition, some health care providers may wish to delete data that they furnished when applying for their NPIs that is optional for inclusion in the NPI database. According to CMS, information provided in these optional fields -- for example "Other Names" and "Other Provider Identifiers" -- is not required. The Federal Register notice includes a table of data elements that are required.

The notice encourages all entities who have been assigned NPIs to review their data and make any necessary updates or corrections within the next 30 days to ensure that their information is accurate before it is posted in the public database. To review their NPI information, physicians can return to the CMS Web site where they applied for their NPI and enter their personal login information to access their original application.