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.
- Source file
- Not reported
- Published
- Not reported
- Retrieved
- Not reported
- Snapshot
- Not retained for this reference page
- Re-check
- CMS NPI Standard overview
- Data as of
- Not reported
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
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.
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