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  1. Fonteum
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  5. NPI Number
Fonteum Data GlossaryProvider

What is an NPI?

An NPI is a permanent, intelligence-free 10-digit National Provider Identifier assigned through CMS NPPES to an eligible individual or organization. Covered healthcare providers use it in HIPAA standard transactions. It does not by itself establish licensure, credentialing, Medicare enrollment, or payment status.

Full name: National Provider Identifier

Short explanation

The National Provider Identifier (NPI) is a unique, 10-digit numeric identifier assigned to health care providers in the United States under HIPAA Administrative Simplification. Administered by CMS through NPPES, an NPI is permanent and does not change when a provider changes their name, address, or taxonomy. All HIPAA-covered health care providers must obtain an NPI for use in administrative and financial transactions, including claims, eligibility inquiries, and remittance advice.

Related data: NPPES provider dataset

Last updated: 2026-07-11Reviewed by: Dr. Jennifer Montecillo, MD — Gullas College of Medicine, 2019. Non-practicing medical reviewer.

How it’s used

  • CMS NPPES NPI Registry: each public record identifies an NPI and can include submitted names, addresses, and taxonomy codes; field availability varies.
  • CMS PECOS Medicare Provider Enrollment: enrollment records cross-reference NPIs against Medicare billing rights and reassignment data.
  • CMS Open Payments: physician payment disclosures are keyed to NPI, enabling financial-relationship lookups by individual provider.
  • CMS QPP MIPS: clinician performance scores are published at the NPI level, making NPI the join key between payment data and quality scores.

Frequently asked questions

What is an NPI number?
An NPI is a 10-digit, intelligence-free identifier assigned through CMS NPPES to an eligible individual or organization. HIPAA-covered healthcare providers must obtain one for standard transactions.
Who needs an NPI number?
All HIPAA-covered health care providers — physicians, nurses, dentists, pharmacists, hospitals, group practices, and others — are required to obtain an NPI for use in electronic administrative transactions.
Does an NPI number change?
No. An NPI is permanent and does not change when a provider changes their name, address, specialty, or employer.
What is the difference between a Type 1 and Type 2 NPI?
A Type 1 NPI is assigned to individual providers (persons). A Type 2 NPI is assigned to organizations such as hospitals or group practices.

Related terms

  • NPPES
  • Type 1 NPI
  • Type 2 NPI
  • Taxonomy Code
  • PECOS
  • UPIN
  • Entity Resolution

Explore in Fonteum

How Fonteum sources, resolves, and publishes data tied to this term.

  • DataNPPES provider dataset
  • PlatformEntity graph — one resolved record per provider
  • PlatformProvider data API
  • Use caseProvider data for credentialing teams
  • StudyWho is enrolled in Medicare (PECOS analysis)

Authoritative sources

  • CMS NPI Standard overview↗
  • NPPES NPI Registry (NPI lookup)↗
  • CMS: NPIs↗
← All glossary terms

What’s on file, by the numbers

Platform snapshot · 2026-07-15

13.4Mproviders & companiesProviders, organizations, owners, and facilities on file
26.2Msource-linked factsSource-linked field facts in the dated platform snapshot
—sources liveCrosswalk-resolved sources with a proved content transition in the preceding 45 days
111sources integratedActive registry rows; integration does not establish a load
13state Medicaid jurisdictionsDistinct states represented in the state-exclusions serving table

Built on the authoritative federal record

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Named medical review

Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

Read the full provenance and attestation methodology →

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Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

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A public-records graph that exposes source and observation metadata where supplied.

Fonteum's provenance ledger contained 26.2M source-linked facts on July 12, 2026. All but 14 carried a source-file SHA-256; 0 linked deterministically to a signature. Inspect a supplied snapshot id at fonteum.com/verify · source-mark coverage and limitations.
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