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National Provider Identifier Standard (NPI)

Medicare NPI Implementation

Transcript for the May 19th NPI Roundtable, Live Q&A Session, Now Available

See the Downloads section below to access the transcript from this Roundtable

Transcript for May 14th NPI Roundtable Now Available

See the Downloads section below to access the transcript from this Roundtable

Helpful MLN Matters Articles for Medicare NPI Implementation

  • SE0725 – common enumeration errors in NPPES, helpful enumeration Dos & Don'ts, and how to use your NPI on Medicare claims
  • SE0744 – Important NPI and Enrollment Information for Physicians and Non-Physician Practitioners
  • MM5595 – Implementation of Medicare FFS Contingency Plan

See below for NPI Related MLN Matters Articles in the Related Links section to view these articles.

The Importance of Reporting Medicare Legacy Numbers in NPPES

The reporting of legacy numbers in the "Other Provider Identifier"/"Other Provider Identifier Type Code" fields in the National Plan and Provider Enumeration System (NPPES) will assist Medicare in successfully creating linkages between providers' NPIs and the identifiers that Medicare has assigned to them (such as PINs).

You should be aware that if you remove your legacy numbers from the "Other Provider Identifier"/"Other Provider Identifier Type Code" fields, linkages that Medicare has established using the reported Medicare legacy numbers will be broken and your Medicare claims could be rejected. 

Transcripts from Medicare Fee-For-Service (FFS) Roundtables Available

See the Downloads section below for transcripts form:

  • April 17, 2008 NPI Roundtable
  • February 6, 2008 NPI Roundtable
  • August 2, 2007 Common Billing Errors Roundtable
  • May 10, 2007 Medicare FFS Contingency Plan Roundtable

Medicare Implementation Timeframes

Medicare's implementation involving acceptance and processing of transactions with the NPI will occur in separate stages, as shown in the document below (See Downloads section.)

Medicare Expectations on Determination of Subparts

The NPI Final Rule requires health care providers who are organizations and who are covered entities under HIPAA to determine if they have "subparts" that should be assigned NPIs.  The NPI Final Rule provides guidance to those health care providers in making those determinations.

We have communicated to the Provider Enrollment staff at the carriers and fiscal intermediaries the Medicare program's expectations concerning the determination of subparts for NPI assignment purposes. We have prepared a document describing the subpart concept and its relationship to the way in which Medicare enrolls its organization providers.  This document will be helpful to carrier and fiscal intermediary staff in understanding the issue of subparts and how subpart determination could be done in a way that helps to promote smoother and more efficient Medicare claims processing during the implementation of the NPI in the Medicare program.

The health care industry in general has expressed an interest in being informed of this type of information.  We post it here so that it is easily available to interested parties.

NPI Question Resource Sheet

Many NPI questions that providers and their staff may have can be answered by the resources provided here on the CMS NPI page. The "NPI Question Resource Sheet" points to specific resources that can help answer common questions (see Downloads section below).

Please note that CMS cannot respond individually to every question submitted as feedback via the website.  However, be assured that we are reviewing all questions to determine if new educational products or "Frequently Asked Questions (FAQs)" are needed or if revisions to existing products or FAQs are warranted.  Please bookmark this website and continue to check for updates to official information and education.  You can also visit the NPI Question Resource Sheet (see Downloads below) for resources on this website that will help answer common questions.


Transcript for May 19th NPI Roundtable [PDF 174KB]

Transcript for May 14th NPI Roundtable [PDF 193KB]

Transcript for April 17th NPI Roundtable [PDF, 223KB]

Transcript for 2/6/08 NPI Roundtable [PDF 182KB]

Transcript for 8/2/07 FFS Medicare Q&A Roundtable [PDF, 146KB]

Medicare FFS Contingency Plan Roundtable Transcript [PDF, 92KB]

Medicare FFS Contingency Plan Change Request [PDF 127KB]

Medicare NPI Implementation Timeframes [PDF, 44 KB]

Medicare Subpart Expectations [PDF, 48KB]

NPI Subject Resource Sheet [PDF, 35KB]
Related Links Inside CMS
NPI Related MLN Matters Articles [PDF, 109KB]

Apply Now  - National Plan and Provider Enumeration System (NPPES)

NPI Frequently Asked Questions (FAQs)
Related Links Outside CMS

There are no Related Links Outside CMS


Page Last Modified: 06/17/2008 1:14:19 PM
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