The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of a standard unique identifier for health care providers. The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information.  The National Plan and Provider Enumeration System (NPPES) collects identifying information on health care providers and assigns each a unique National Provider Identifier (NPI).  

The purpose of the National Provider Identifier (NPI) is to uniquely identify a health care provider in standard transactions, such as health care claims. NPIs may also be used to identify health care providers on prescriptions or lab orders, in coordination of benefits between health plans, in patient medical record systems, and in other ways. HIPAA requires that covered entities (i.e., health plans, health care clearinghouses, and those health care providers who transmit any health information in electronic form in connection with a transaction for which the Secretary of Health and Human Services has adopted a standard) use NPIs in standard transactions by the compliance dates. The compliance date for all covered entities except small health plans is May 23, 2007; the compliance date for small health plans is May 23, 2008. As of the compliance dates, the NPI will be the only health care provider identifier that can be used for identification purposes in standard transactions by covered entities.

To prepare for this date of compliance, it is advisable for all NDs to apply for their NPI now to facilitate a smooth transition.  Those of you who contract with third party payers or reference laboratories may have already been encouraged to do this and will soon be given instructions about how to implement the new identifier over the coming months. 

To apply for you NPI online, visit https://nppes.cms.hhs.gov.  You will be asked for standard identifying information and will have to select your provider taxonomy (naturopath is specified after you select “other” in the initial menu).  There is no fee to apply.  Numbers are usually issued in 2-7 business days.   If you have questions, there is a FAQ link on the webpage listed and there is also an NPI hot line 1-800-465-3203.