What is an NPI number, who needs one, how do you get one, or when do you need two NPI are just a few of the questions that have arisen.
What is an NPI Number?
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. It is a 10-digit numerical identifier used to identify an individual provider or a health care entity. Covered health care providers, all health plans, and health care clearinghouses must use NPI numbers in the administrative and financial transactions adopted under HIPAA.
Who Is Eligible for an NPI?
A National Provider Identifier, or NPI, is available for all individuals and organizations that meet the concept of health care provider as defined in CFR 160.103. These are classified as below:-
1. Ambulance companies
3. Clinical Social Workers
4. Clinical Therapists
7. Group Practices
8. Health care clearinghouses
9. Health care plans
10. Home health care agencies
12. Licensed Therapists
13. Medical Equipment suppliers
14. Medical Laboratories
16. Nursing homes
21. Physical therapists
23. Physician Assistants
25. Residential Treatment Centers
Do nurses have an NPI number?
Yes. Nurse practitioners and physicians assistants need to have one as well as midwives. HIPAA says that all health providers must have an NPI. When it says health care providers then it means a provider of services (as defined in section 1861(u) of the Act, 42 U.S.C. 1395x (u)), a provider of medical or health services (as defined in section 1861(s) of the Act, 42 U.S.C. 1395x(s)), and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business.
Type of NPI required by the Nurse practitioner
Generally, there are two types of NPI and these are as follow:-
Type 1:- It is required by individuals or sole practitioners such as doctors, nurses, etc.
Type 2:- It is required by organizations such as hospitals, nursing homes, etc.
Here we can say that nurses can apply for Type 1 NPI.