NPI Number (National Provider Identifier) Directories for NPI
Lookup and UPIN Crosswalks
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.We offer
NPI number records in the following electronic
formats:
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.

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.
|