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 HIPAA – Health Insurance Portability and Accountability Act title
  
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Identifier Standards

HIPAA established a standard for unique national provider, employer and health plan identifiers and requirements concerning their use by health plans, healthcare clearing houses, and healthcare providers. These unique identifiers must be used among other uses, in connection with certain electronic transactions.

National Provider Identifier

  • National Provider Identifier (NPI) Final Rule Published - The Final Rule adopting the HIPAA standard unique health identifier for health care providers was published in the Federal Register on January 23, 2004. Health care providers can begin applying for NPIs on the effective date of the final rule, which is May 23, 2005. All health care providers are eligible to be assigned NPIs; health care providers who are covered entities must obtain and use NPIs. All HIPAA covered entities must use NPIs by the compliance dates (May 23, 2007 for all but small health plans; May 23, 2008 for small health plans). Click here to view the final rule [PDF].

  • OVERVIEW of the NPI Final Rule [PDF]
  • Proposed Rule published in the Federal Register on May 7, 1998 - Comment period ended July 6, 1998
  • Comments on Proposed Rule
  • System of Records Notice published in the Federal Register on July 28, 1998
  • Requirements for NPI and NPI Check Digit [PDF]
  • National Provider Identifier (NPI) enumerator contract - a presolicitation notice has been released. Click here for the synopsis. For more information, click here.
  • The attached letter of May 6, 2005, explains the first stage of the formal CMS outreach to providers on applying for a National Provider Identifier. Review the letter [WORD 48k].
  • An instructional web tool, called the NPI Viewlet, is now available for viewing at www.cms.hhs.gov/medlearn/npi/ and under "HIPAA Latest News" at www.cms.hhs.gov/hipaa/hipaa2 on the Centers for Medicare & Medicaid Services' (CMS) website. This tool provides an overview of the NPI, a walkthrough of the application, as well as live links to the National Plan and Provider Enumeration System's (NPPES) website where the learner can apply for an NPI. This tool is designed for all health care providers. In the near future, you will also be able to access the viewlet at https://nppes.cms.hhs.gov on the web.

National Employer Identifier
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This file last modified: Friday March 28, 2008  11:47 AM