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NPI Number (National Provider Identifier) Directories for NPI Lookup and UPIN Crosswalks, Version 4 (Apr '08)
After providers complete their NPI application, they need NPI Number directories
for NPI lookup and UPIN crosswalks to complete
medical claims. Provistas has added matched an additional 73,198 UPIN
to NPI records that were not included by individual providers.
The latest NPI version contains an additional 249,650 new provider records
and 19,891 new organization records.
We offer
NPI number records in the following electronic
formats:
-
Downloadable NPI number ASCII data files and
Access databases for the
entire nation and individual states and territories - Use
these files in spreadsheet or database program. Due large number of
records, we have split the data into two sets of files, one for
individual providers and one for healthcare organizations.
-
Downloadable NPI number eBooks that are searchable
and printable in Adobe Acrobat Reader. Each contains a separate
indexes organized by name, NPI number, and UPIN to make finding a provider
as easy as possible. Again, due to the number of records, the
eBooks have been split into individual provider and organization
files.
NPI numbers for our NPI lookup files are released every other 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:
-
Simplify Electronic Billing using mandated HIPAA transaction standards
-
Replace multiple legacy identifiers like UPINs with a single identifier
-
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.
Downloadable NPI number ASCII data files and Access databases for the entire nation and individual states and territories - Use these files in spreadsheet or database program. Due large number of records, we have split the data into two sets of files, one for individual providers and one for healthcare organizations.
Downloadable NPI number eBooks that are searchable and printable in Adobe Acrobat Reader. Each contains a separate indexes organized by name, NPI number, and UPIN to make finding a provider as easy as possible. Again, due to the number of records, the eBooks have been split into individual provider and organization files.
Simplify Electronic Billing using mandated HIPAA transaction standards
Replace multiple legacy identifiers like UPINs with a single identifier
Speed Coordination of Benefits (COB) payments
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
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
NPI Frequently Asked Questions can be accessed by clicking here.
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