How to apply for NPI number ? (2023)

Wondering how to apply for an NPI number? Yes, you are at the right place to learn about applying for an NPI number.

In this guide, we will discuss the following topics regarding NPI.

1. How to apply for NPI number?

2. How to apply for NPI as an individual or group/organization?

3. How long will it take to get NPI?

4. How to find your NPI number?

5. How to get Medicare details of the NPI number? 

We will discuss each of these in detail below.

How to apply for NPI number?

National Provider Identifier (NPI) is to uniquely identify a health care provider in standard transactions, such as health care claims. You can apply for an NPI in one of three ways:

1. Online Application

2. Postal Mail in a written format

3. Via an electronic file interchange (EFI) provided by an (EFIO) organization

How to apply for NPI online?

The quickest and easiest way to apply for national provider information (NPI) will be by completing the online application. To complete the application you will need:

1. License numbers
2. Legacy (current) provider identification numbers
3. Phone number 
4. Taxonomy codes
5. UPIN number
6. Mailing and practice address(es)
7. Name of the person who will serve as a contact should the enumerator need further information.

If you have someone other than yourself complete the application, then they will also need to know in what country and state you were born, your date of birth, your social security or individual taxpayer identification number etc.

Follow the below steps to apply online for an NPI number.

Visit the NPPES website.

Select Create or Manage an Account.

Click on OK to the Leaving NPPES Website.

Read the Terms and Conditions and then click on ACCEPT.

Click on Create Account Now.

Enter details as per the page requirements on this page and subsequent screens to set up password and security questions

Setup Multi-factor authentication (MFA) and once you receive the code, enter the 6-digit code and click on Verify code.

Select COMPLETE REGISTRATION option to complete the registration process or choose Begin Alternative Setup option can be used to set up an additional form of MFA.

How to apply NPI via Postal Form?

If you wish to complete a paper application/update form (CMS-10114), this must be obtained by contacting the NPI Enumerator. Health care providers who wish to obtain a copy of this form must contact the NPI Enumerator in any of these ways:

• Phone: (800)465-3203 or TTY (800)692-2326.
• Email: [email protected].
• Mail: NPI Enumerator, P.O. Box 6059, Fargo, ND 58108-6059

How to apply NPI via EFIO? 

Electronic File Interchange (EFI), also referred to as bulk enumeration, is a process by which physician and other health care providers (hereinafter simply referred to as provider) or group of providers can have a particular organization (the EFIO) apply for NPI on their behalf. In other words, rather than a provider or group of providers submitting a paper or web NPI application, the EFIO obtains an NPI for him/her/them.

What makes EFI so unique is that one file can contain hundreds or thousands of providers’ applications. By submitting these applications both simultaneously and electronically, the administrative and financial burdens for both the provider community and the U.S. Department of Health and Human Services (HHS) are greatly reduced. These benefits are enhanced because EFI can also be used to change or update a provider’s existing NPI information.

See the CMS Electronic File Interchange Summary for more information on the EFI process.

How to apply for an NPI as an individual or group/organization?

There are two types of NPI to apply: 

1. Sole Proprietorships (Type I / Type 1 NPI Number)

If you practice as an individual/sole proprietorship, you must apply for NPI as a type I (individual). You will have to submit your social security number (rather than your employer identification number) 

2. Incorporated Practices (Type II / Type 2 NPI Number)

Eligible organizations, including S corporations, may apply for an NPI as an entity Type II (organization). Eligible individuals working within an organization, including an S corporation, may also apply for an NPI as an entity Type I (individual). An S corporation representing only one practitioner is still eligible for a Type II NPI. From an NPI perspective, an S corporation is no different than a limited liability corporation or any other type of corporation.

How long will it take to get NPI? 

You may apply NPI via varied methods. Typically, it might take as little as 10 days for a properly completed electronic application to receive their NPI, although this may vary depending upon the applications volume at any given time.

How to find my NPI number? 

The NPI Registry Public Search is a free directory of all active National Provider Identifier (NPI) records. You may also use other NPI websites to perform an NPI Lookup. These sites would run a check with the NPI database and is regularly updated with the latest NPI information provided by NPPES. The websites will aid in searching by your first name etc., to find your NPI number

How to get Medicare details of the NPI number? 

The Medicare details of an NPI number is typically available in the Centers for Medicare & Medicaid Services. Alternate NPI websites are also available which aids in finding out if an NPI number has Medicare details.

FAQs

Wrapping Up

Hope you get an idea about applying for an NPI number. Kindly let us know if you have any queries.