Frequently Asked Questions

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By Topic: HIPAA Administrative Simplification Subtopic: National Provider Identifier Standard (NPI)

What should a health care provider do if its National Plan and Provider Enumeration System (NPPES) data tha...
Health care providers who notice that their records are incorrect may update their information in NPPES at any time. The... (more)

When is an National Provider Identifier (NPI) entered in block 32.
Medicare does not require an National Provider Identifier (NPI) in block 32a nor a legacy number in 32b. If you are usin... (more)

If a health care provider deactivates its National Provider Identifier (NPI), will its record still be in t...
No. Neither the downloadable file nor the query-only database will contain information about health care providers whose... (more)

Will it be difficult to download the downloadable file?
The initial downloadable Zip file, as well as each monthly update Zip file, is a compressed archive file that will conta... (more)

Do I need a National Provider Identifier (NPI) to make changes to my Medicare enrollment information?
Yes, Medicare providers must provide their NPIs when making any changes to their Medicare enrollment information.... (more)

When will CMS update the Certificate of Medical Necessity Forms to add National Provider Identifiers (NPIs)?
All CMS Certificate of Medical Necessity forms have been updated to accept the NPI. You can find these forms on the CMS ... (more)

Do I need a National Provider Identifier (NPI) to enroll in the Medicare Program?
Yes, an National Provider Identifier (NPI) must be included on the CMS-855 enrollment application.... (more)

How do I share my National Provider Identifier (NPI) with Medicare?
Please share your NPI with Medicare by submitting it, along with appropriate legacy identifiers, on Medicare claims.... (more)

Your website states that the National Provider Identifier (NPI) will replace legacy identifiers; what are t...
By “legacy identifiers,” we mean identification numbers that entities, such as health plans, have assigned to health... (more)