The purpose of the National Provider Identifier (NPI) is to uniquely identify a health care provider in standard transactions, such as health care claims. NPIs can also be used to identify health care providers on prescriptions, in internal files to link proprietary provider identification numbers and other information, in coordination of benefits between health plans, in patient medical record systems, in program integrity files, and in other ways.
HIPAA requires that covered entities (health plans, health care clearinghouses, and those health care providers who transmit any health information in electronic form in connection with a transaction for which the Secretary of Health and Human Services has adopted a standard) use NPIs in standard transactions by the compliance dates, after which time the NPI will be the only health care provider identifier allowed for identification purposes in standard transactions by covered entities.
The NPI is all numeric and is 10 positions in length: the first 9 positions are the identifier, and the last position is a check digit, which helps detect invalid NPIs.
