NPI Rule and Regulations
NPI Rule and Regulations
What the Rule Does
Important Links
NPI Rule and Regulations
Purpose - Establishes the standard for the unique health identifier for health care providers to simplify the administration of the health care system. Defines the National Provider Identifier (NPI) as the standard, and identifies the implementation specifications for obtaining and using the standard.
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What the Rule Does:
Establishes the Standard: The National Provider Identifier (NPI) is the unique health identifier for health care providers. The NPI is a 10-digit numeric identifier with a check digit.
Establishes the National Provider System: The National Provider System (NPS) will be the system used to assign unique numbers to health care providers.
Defines Implementation Specifications for Covered Entities: Health Care Providers must obtain an NPI and use it on standard transactions; Health Plans and Health Care Clearinghouses must use the NPI to identify health care providers on standard transactions where the health care provider’s identifier is required.
Defines Compliance Dates for Implementation of the NPI: Health Care Providers, Health Plans (except small health plans), and Health Care Clearinghouses must comply with the NPI implementation specifications no later than May 23, 2007. Small Health Plans must comply with the NPI implementation specifications no later than May 23, 2008.
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Important links:
Click here to read the NPI Rule: NPI Rule (pdf)
Centers for Medicare and Medicaid Services (CMS) NPI website: http://www.cms.hhs.gov/NationalProvIdentStand/
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