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NPI Number (National Provider Identifier) Directories for NPI Lookup and UPIN Crosswalks

June 2009 Version (v13) contains an additional 11578 new providers and 3926 new organizations.

Medical Coding .Net has created NPI directories in downloadable databases and eBooks to help you prepare medical claims. NPI files are released monthly and include UPIN crosswalks. This website always has the most current file, which replaces any prior. Do not purchase data files unless you understand how to download ZIP files from the Internet and can manage the data using spreadsheet or database programs. Because of the whole US file sizes, you need a database to manage the data. All downloadable sales are non-refundable so please contact us if you have any questions prior to purchasing. Save when you order a monthly data file subscription! To order a subscription or if you need us to ship a CD-ROM, please call 888-288-2043 x2.

State SpeedEBooks | State and National Data Files

NPI Organizations & Providers State SpeedEBook Package
Only $19.95!
Provistas NPI SpeedEBooks™, printable PDF directories, help you prepare medical claims. Customized by state, SpeedEBooks have three ways to look up providers: by name, NPI, or UPIN.

To place an order, click the state(s) above. Hold the CTRL key while clicking to select multiple states. Then click the Add to Cart button to start your checkout. You will be presented with the download link(s) after completing the purchase.

For best viewing, click the HQ and fullscreen buttons below. The Esc key will return to the video to normal size. A final video one printing the NPI SpeedEBooks will be available shortly.
Provistas SpeedEBooks™ are immediately downloadable. Acrobat Reader is required to read them. You can download this free program by clicking the picture. All eBooks sales are final.

State SpeedEBooks | State and National Data Files

NPI Individual Provider & Organizations Package
Only $24.95

To order and download state tab-delimited data files, first click the state name. You may need to scroll up or down. Hold the CTRL key while clicking to select multiple states. Last click the Add to Cart button to start your checkout. Download links are presented after completing the purchase.

The individual provider file contains names, credentials, specialty, practice state license, mailing and practice addresses, practice phone and fax, and dates for NPI activation, deactivation, and reactivation of the 1.7 million healthcare providers who participate in electronic billing.

The organizations file contains 530,000 organization names, mailing and practice addresses, practice phone and fax, contact individual, and dates for NPI activation, deactivation, and reactivation.

To order the national databases below, click the checkbox and then click Add to Cart above.
NPIUSB-F
Do not purchase without a high speed Internet connection.		 NPI Organizations and Individual Provider Tab-Delimited Data Files (200MB download)
The same format as the individual state files above but for the entire nation.		 $249.95
NPIUSB-MDB
Do not purchase without a high speed Internet connection.		 NPI Access Databases of Providers and Organizations (350MB download)
If you are running Access 2000 or higher, you can open this database right away.		 $349.95
 

NPI numbers for our NPI lookup files are released every month. This website always has the most current.

The National Provider Identifier, or NPI number, is assigned to every licensed healthcare provider (physicians and non-physician providers). NPI numbers follow the providers/suppliers across all practice settings, locations, and last their entire career. NPI numbers are 10-digits long with the last digit being a check digit. An NPI number is "intelligence-free" meaning it contains no information about the provider encoded in the digits.

NPI numbers were required by the Healthcare Portability and Accountability Act in order to:

  1. Simplify Electronic Billing using mandated HIPAA transaction standards

  2. Replace multiple legacy identifiers like UPINs with a single identifier

  3. Speed Coordination of Benefits (COB) payments

An NPI number will not:

  • Eliminate or replace the provider enrollment processes conducted by health plans

  • Guarantee reimbursement by any health plan

  • Convey covered entity status

  • Assure licensure or credentials

NPI numbers are entered in box 17b of the CMS-1500 form

This box identifies the referring or ordering provider for services that the billing provider or supplier performs. These types of services can include lab tests, x-rays, or consultations.

 

 

 

From the National Uniform Claim Committee 1500 Health Insurance Claim Form Reference Instruction Manual for 08/05 Version

 

 

Title 17b: NPI #

Instructions 17b: Enter the NPI number of the referring provider, ordering provider, or other source in Item Number 17b.

Description: The NPI number refers to the HIPAA National Provider Identifier number.

Field Specification: This field allows for the entry of a 10 digit NPI number.

NPI Frequently Asked Questions

  Question
1 Who’s National Provider Identifier (NPI) should be in the Attending Physician NPI field on claims for institutions submitting vaccine roster bills for fiscal intermediaries (FIs) or regional home health intermediaries (RHHIs) when an NPI is
2 How do covered entities implement the NPI where the adopted versions of the Implementation Guides appear to allow the use of other health care provider identifiers in addition to the NPI?
3 I applied for my National Provider Identifier (NPI) over the web and haven’t received the NPI Notification. What should I do?
4 How can a health care provider document the assignment of an NPI?
5 Can providers from foreign countries request an NPI, despite the fact that the provider is not a US provider? Or, would the NPI application be denied in this case?
6 If a health care provider deactivates its National Provider Identifier (NPI), will its record still be in the downloadable file and the query-only database? How will it be known that the NPI was deactivated?
7 How can a health care provider apply for and obtain a National Provider Identifier (NPI)?
8 After the compliance date for the NPI, can a covered health care provider continue to use other numbers, such as legacy or proprietary identifiers, in addition to its NPI, to identify itself?
9 How will the acceptance and processing of transactions with the National Provider Identifier (NPI) occur?
10 If an Electronic File Interchange (EFI) Organization obtained my National Provider Identifier (NPI) for me, how do I obtain a copy of the NPI notification?
11 How does a rendering physician report their National Provider Identifier NPI) on a claim that includes Physician Quality Reporting Initiative (PQRI) quality data codes? What if he/she is part of a group and the group NPI is used on the
12 What is the purpose of the NPI? Who must use it, and when?
13 Will a health care provider continue to use other numbers besides the NPI?
14 Is a health care provider required to obtain a National Provider Identifier (NPI)?
15 Who is eligible to receive a National Provider Identifier (NPI)?
16 What is the format of the NPI?
17 Will a health care provider’s National Provider Identifier (NPI) ever change?
18 Under what circumstances will a claim be rejected when using the National Provider Identifier (NPI)?
19 How long will it take to get an NPI?
20 With whom should I share my National Provider Identifier (NPI)?

NPI Frequently Asked Questions can be accessed by clicking here.

 
 
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