When the number is used
Your provider must submit the NPI number each time they make and report a HIPAA transaction. These events include examination and treatment of patients; submitting and verifying applications for insurance benefits, patient referrals, and prior certification or prior approval of services.
In addition to doctors, dentists, pharmacists, nurses, chiropractors, physical therapists, nursing homes, ambulance companies, and medical device providers are among the providers who must carry an NPI number. Those who provide services, such as non-emergency ambulance transportation, housekeeping, and the installation of guardrails or ramps to accommodate people with disabilities, are not considered health care providers and do not receive an NPI number. .
Doctor or number lookup
The National Plan and System Provider Enumeration maintains a database for you to find the provider’s NPI number or provider identity. The NPI registry will give you, in addition to the NPI, the provider’s address, type of service or general area of practice, and the insurers accepted by the provider.