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Provider Number/National Provider Identifier (NPI) FAQs

 1. What are the rules for using the provider number?  Each approved provider has agreed to abide by all program requirements published in the Medi-Cal provider manual. No provider shall submit claims to the Medi-Cal program using any provider number other than that issued to the provider by DHCS, or their assigned NPI number.

Providers agree that they have no property right in or to their status as a provider in the Medi-Cal program or in or to their provider number(s), and that a provider may not assign their provider number or any rights and obligations it has under a Medi-Cal Provider Agreement, unless allowed as described in the Requirements and Procedures for Successor Liability article.

2. Who do providers contact regarding a lost provider number?  If a provider number is lost, the provider must submit a Medi-Cal Provider Number Verification Form to PED. The request must be signed by the provider and include a photocopy of his or her medical license, and driver’s license, or state-issued identification card. This form can be found online on the Provider Enrollment page, under Application Packages Alphabetical by Provider Type.

 

For more information on NPI including application and FAQs, visit www.cms.gov/NationalProvIdentStand/.