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The NPI does not replace the function of the DEA Number, which is to identify the prescriber of a controlled or dangerous substance. The NPI was adopted to identify a health care provider as a health care provider in standard transactions adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). A health care provider who is a covered entity under HIPAA is required to obtain an NPI, and to use that NPI to identify itself as a health care provider in HIPAA standard transactions. Health care providers who are not covered entities under HIPAA, but who prescribe medications, order services for patients, refer patients to other providers, or who otherwise need to be identified in HIPAA standard transactions that are conducted by other health care providers, will need (but are not required) NPIs so that those other health care providers can use that number to identify them in the HIPAA standard transactions that they conduct. The definition for a HIPAA covered health care provider may be found at 45CFR 162.103.
(FAQ2091)
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