NPI: Get It. Share It.Use It.
NPI – An Overview
This document provides a general overview of the NPI, including background
information, how to obtain an NPI, provider responsibilities associated
with the NPI, and how the NPI may affect provider reimbursement and cash
flow.
NPI Subpart Enumeration
How Many Organizational Type 2 NPIs Will Your Practice Need?
This document provides guidance to assist provider practices in determining
whether they will need to obtain an Organizational Type 2 NPI. It also
provides guidance in determining if subpart enumeration is necessary –
that is, if a provider practice needs to obtain multiple Organizational
Type 2 NPIs.
NPI Timelines
The following documents illustrate critical dates for NPI implementation,
as well as critical dates for the release and use of the revised CMS-1500
(08/05)
and UB-04.
• NPI Important Dates 
• NPI CMS Requirements for Professional
Claims - CMS-1500 (12/90) and CMS-1500 (08/05)
• NPI CMS Requirements for Institutional
Claims - UB-92 and UB-04
NPI Contingency Plan Information
• CMS
Guidance
• WEDI
Contingency Plan Guidance
• CareFirst
• United
Health Care
• Aetna
• Cigna
Maryland Medicaid NPI Information - NEW
Guide to NPI Data Fields on the Revised
CMS-1500 and the Electronic Claim File (837P)
This guide compares the paper CMS-1500 (12/90) to the CMS-1500 (08/05),
as well as the electronic professional claim (837P), before and after
the NPI goes into effect on May 23, 2007. If printing this document, please
note that it must be printed on legal-size paper.
Sample NPI On-line Applications
• Sample Individual Type 1 NPI Application
• Sample Organizational Type 2 NPI Application
Additional Sources of NPI Information
• CMS NPI Information (http://www.cms.hhs.gov/NationalProvIdentStand/)
The CMS website containing NPI educational tools and directives, including
a CMS presentation on Subparts 
.
• The
Workgroup for Electronic Data Interchange (WEDI) NPI Outreach Initiative The WEDI NPI website is a good source of analysis and guidance on NPI.
While WEDI membership is required to access some documents, several are
available to the public at large.
• NUCC CMS-1500 (08/05) Information
The National Uniform Claim Committee website, which contains detailed
information about the revised CMS-1500 (08/05).
• NUBC UB-04 Information
The National Uniform Billing Committee website, which contains detailed
information about the revised UB-04.
• NDEDIC – NPI Facts
The National Dental EDI Council is an organization dedicated to advancing
the value and utilization of electronic connectivity in the dental community.
This document provides useful information for all providers.
Getting an NPI is free – not having one can be costly
Last Updated September 28, 2006
