A guide to the National Provider Identifier (NPI)
Your National Provider Identifier (NPI) uniquely identifies physicians in health care transactions. Learn about what it is, how to apply for it and more.
What is an NPI number?
An NPI is a way for insurance companies and other entities to identify your practice. NPIs may also be used to identify health care providers on prescriptions, in internal files to link proprietary provider identification numbers and other information, in coordination of benefits between health plans, in patient medical record systems, in program integrity files and in other ways.
HIPAA requires that covered entities use NPIs in standard transactions. You are a covered entity if you conduct any electronic transaction with federal health programs.
How to apply for your NPI
Regardless of how you apply, you’ll need the following information:
Legacy (current) provider identification numbers
UPIN number
Taxonomy codes
License numbers
Mailing address and practice address(es)
Phone number and the name of the person who will serve as a contact should the enumerator need further information
Application options
The fastest way to apply for your NPI is to complete your application online. If you have someone other than yourself complete the application, they will also need to know in what country and state you were born, your date of birth, and your social security or individual taxpayer identification number.
What if my employer applies for my NPI?
Your individual NPI is yours even if your employer files the application for it. The NPI does not change when you change practices or work in different settings. You will have only one individual NPI. It will be used by all health plans who are covered entities, eliminating what are likely many provider numbers assigned by Medicare, Medicaid, and private payers at present.
What is my taxonomy number?
Physicians may report primary and secondary taxonomy codes in the NPI application. For instance, a family medicine physician specializing in adolescent medicine might report a primary code for family medicine, 207Q00000X, and a secondary code for adolescent medicine, 207QA0000X.
Taxonomy number registry
|
FAMILY PRACTICE |
207Q00000X |
|
Addiction Medicine |
207QA0401X |
|
Adolescent Medicine |
207QA0000X |
|
Adult Medicine |
207QA0505X |
|
Geriatric Medicine |
207QG0300X |
|
Sports Medicine |
207QS0010X |
|
GENERAL PRACTICE |
208D0000X |
|
HOSPITALIST |
208M0000X |
|
EMERGENCY MEDICINE |
207P0000X |
|
Emergency Medical Services |
207PE0004X |
|
Medical Toxicology |
207PT0002X |
|
Pediatric Emergency Medicine |
207PP0204X |
|
Sports Medicine |
207PS0010X |
|
Undersea and Hyperbaric Medicine |
207PE0005X |
|
INTERNAL MEDICINE |
207R00000X |
|
Addiction Medicine |
207RA0401X |
|
Adolescent Medicine |
207RA0000X |
|
Allergy and Immunology |
207RA0201X |
|
Cardiovascular Disease |
207RC0000X |
|
Clinical and Laboratory Immunology |
207RI0001X |
|
Clinical Cardiac Electrophysiology |
207RC0001X |
|
Critical Care Medicine |
207RC0200X |
|
Endocrinology, Diabetes and Metabolism |
207RE0101X |
|
Gastroenterology |
207RG0100X |
|
Geriatric Medicine |
207RG0300X |
|
Hematology |
207RH0000X |
|
Hematology and Oncology |
207RH0003X |
|
Hepatology |
207RI0008X |
|
Infectious Disease |
207RI0200X |
|
Interventional Cardiology |
207RI0011X |
|
Magnetic Resonance Imaging (MRI) |
207RM1200X |
|
Medical Oncology |
207RX0202X |
|
Nephrology |
207RN0300X |
|
Pulmonary Disease |
207RP1001X |
|
Rheumatology |
207RR0500X |
|
Sports Medicine |
207RS0010X |
For family nurse practitioners, the taxonomy code is 363LF0000X.
For family medicine clinical nurse specialist, the taxonomy code is 364SF0001X.
Physician assistants in the medical practice are assigned taxonomy code 363AM0700X.
For students, taxonomy code 390200000X is assigned.
Interns should report the general practice taxonomy code 208D00000X.
Residents should report the taxonomy code for the specialty of the residency program.
If applying for an NPI for an organization, a group taxonomy code may be required. For taxonomy codes, a group practice is defined as a business entity under which one or more individuals practice. A group does not require multiple professional providers.
A single provider group is a valid group and would be identified by the business entity name. For example, John Doe, PC. For single specialty groups, the taxonomy code is 193400000X. For multispecialty groups, the taxonomy code is 193200000X.
Frequently asked questions about NPIs
You must notify the enumerator of any changes within 30 days of the change. Most changes will not change your NPI number. Only rare circumstances such as fraudulent use of your NPI number will require that you be issued a new number.
You can change the information in your NPI file online. You may either create a user ID or, if you have one already, log in and update your information. Download the form to make your change by mail.
CMS has created an online NPI registry where a physician, other health care provider or organization can access NPI information. This is part of the same National Plan and Provider Enumeration System (NPPES) web site on which NPI registry is completed.
Only the health care provider data elements that are disclosable under the Freedom of Information Act (FOIA) are released.
Social Security Numbers (SSNs), Internal Revenue Service Individual Taxpayer Identification Numbers (IRS ITINs) and dates of birth (DOB) are not disclosable under FOIA and, therefore, will not be released to the public.
The CMS NPI Dissemination has more information regarding the disclosure of NPI information.
Yes. Like UPIN numbers that were used prior to the establishment of the NPI, other physicians and providers to whom you refer will need your NPI number in order to submit claims for services for patients you refer to them.
If another party does billing on your behalf, that party will need your NPI.
You may also need NPI numbers from hospice and home health agencies and other physicians in order to bill for your services.