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 phone:

By e-mail at:

By mail at:

1-800-465-3203 (NPI Toll-Free)
1-800-692-2326 (NPI TTY)

customerservice@npienumerator.com

NPI Enumerator
PO Box 6059
Fargo, ND 58108-6059

 

 

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:

 

https://nppes.cms.hhs.gov/

 

https://nppes.cms.hhs.gov/   or   CALL 1-800-465-3203 FOR A PAPER COPY