PACE
Provider
Bulletin
June 30, 2006
NATIONAL PROVIDER IDENTIFIER
(NPI)
On January 23, 2004, The Centers for
Medicare & Medicaid Services (CMS) announced the availability of a new
identifier for use in the standard electronic health care
transactions.
The National Provider Identifier
(NPI) will be the single provider identifier, replacing the numerous provider
identifiers currently used by each health plan. This identifier, which
implements a requirement of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), must be used by most HIPAA covered entities that conduct
electronic transactions.
The Centers for
Medicare & Medicaid Services (CMS) has developed the National Plan and
Provider Enumeration System (NPPES) to assign these
unique identifiers.
CMS has contracted
with Fox Systems, Inc. to serve as the NPI
Enumerator.
The NPI Enumerator is
responsible for dealing with health plans and providers on issues relating to
unique identification.
The NPI Enumerator may
be contacted as follows:
|
|
|
By mail
at: |
|
1-800-465-3203
(NPI Toll-Free) |
customerservice@npienumerator.com
|
NPI
Enumerator |
All providers submitting claims to
Programs under the auspices of the Department of Aging must apply for this
identifier. The Program should be notified in writing upon its receipt.
In the months ahead, PACE will
provide specific information on the implementation date of the system conversion
to the NPI as well as the deadline for all PACE providers to have notified the
Program of this number.
PACE WILL REQUIRE THIS IDENTIFIER
FOR CLAIMS PROCESSING NO LATER THAN MAY, 2007.
PROVIDERS MAY APPLY FOR THEIR NPI THROUGH:
- WEB BASED APPLICATION AT:
- COMPLETE A PAPER APPLICATION
AVAILABLE ON:
https://nppes.cms.hhs.gov/ or CALL 1-800-465-3203 FOR A PAPER
COPY
- WITH YOUR PERMISSION, YOUR
PROFESSIONAL ORGANIZATION, ASSOCIATION OR EMPLOYER CAN SUBMIT AN ELECTRONIC
FILE WITH YOUR INFORMATION ON YOUR BEHALF.