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The Centers for Medicare and Medicaid Services (CMS) developed a database of questions and answers concerning the National Provider Identifier (NPI). Emdeon Business Services reviewed this information and compiled the questions we thought would be most useful to our clients. (To access the answer to a question, hold the Ctrl key while clicking the link with the left button of your mouse.)

You can review the full database of NPI questions and answers by visiting the CMS website at http://www.cms.hhs.gov and following the NPI links.

COVERED ENTITIES

CMS FAQ #

6594	What types of business structures are considered organization health care providers and thus eligible for organization National Provider Identifiers (NPIs)? What types are not?
8318	New - When should a covered entity announce its (NPI) contingency plan?
8317	New - What will CMS be looking for in an acceptable National Provider Identifier (NPI) plan?
All Providers

CMS FAQ #

8204	Who is not eligible to apply for a National Provider Identifier (NPI)?
5816	How do covered entities implement the NPI where the adopted versions of the Implementation Guides appear to allow the use of other health care provider identifiers in addition to the NPI?
2626	How can a health care provider apply for and obtain a National Provider Identifier (NPI)?
2632	Will a health care provider continue to use other numbers besides the NPI?
2623	What is the purpose of the NPI? Who must use it, and when?
2621	Who is eligible to receive a National Provider Identifier (NPI)?
7965	How do I share my NPI with Medicare?
6929	Under what circumstances will a claim be rejected when using the National Provider Identifier (NPI)?
6930	During Stage 2, can an X12 837 claim be submitted with only a National Provider Identifier (NPI) for a provider?
8300	With whom should I share my National Provider Identifier (NPI)?
8301	I have been told to protect my National Provider Identifier (NPI), and I have been told to share my National Provider Identifier (NPI) - How am I to protect my NPI if I must share it with others?
7952	How does a provider determine how to submit electronic data interchange transactions which are compliant with the HIPAA and NPI requirements?
8319	New - How will covered entities decide when to end their contingency plans?
2746	Can a health plan require that a provider use NPIs after the effective date, but prior to the compliance date?
8325	New - Why is the contingency period limited at all?
8320	New - Will Medicare have a contingency plan and what will it be?
8321	New - Does this mean that providers have an additional 12 months to obtain and begin using NPIs?
8068	If provider Y has both Type 1 and Type 2 NPIs do we need to place Type 1 or Type 2 on the CMS 1500?
6927	What are the key elements of the Crosswalk between National Provider Identifiers (NPIs) and legacy identifiers that will be used during Stage 2?
7298	Should I keep a copy of the National Provider Identifier (NPI) notification that I received from the National Plan and Provider Enumeration System?
8299	Am I required to share my National Provider Identifier (NPI) with health plans, other providers and any other entity that requests it?
6932	What is the transition period for the revised CMS-1500 and the UB-04 forms?
6926	Under the National Provider Identifier (NPI), what are primary and secondary providers?
Institutional Providers

CMS FAQ #

7896	Should all institutional providers submit a taxonomy code on their claims after the implementation of the National Provider Identifier (NPI)?
Pharmacy

CMS FAQ #

8199	I have a Drug Enforcement Administration (DEA) Number. Do I need a National Provider Identifier (NPI) as well?
6148	What identifiers can be used in Medicare e-prescribing on an interim basis before the NPI is required?
6147	Will the National Provider Identifier (NPI) be used as the standard identifier for e-prescribing transactions?

The questions and linked answers found in this document were acquired directly from the CMS website. Emdeon Business Services did not create nor does it maintain the information in this FAQ.