As an insurance billing company, Holistic Billing has new providers contacting us daily about how to start medical billing. The first step is to get a National Provider Identifier number otherwise known as your NPI number. However, many holistic practices are unaware of how to apply for an NPI.
Luckily, the application process for getting an NPI number is pretty straightforward. Follow this guide and the NPI application checklist to help your holistic practice obtain its NPI!
What is an NPI?
A National Provider Identifier, or NPI, is a 10-digit identification number issued to healthcare providers in the U.S. by the Centers for Medicare and Medicaid Services. Your NPI will not change, even if your address, taxonomy, or name changes. Although every NPI is unique, it does not carry specific information about you, such as the state where you practice or your specialization.
The NPI must be used in place of other provider identifiers, such as a Provider Transaction Access Number (PTAN), Online Survey Certification & Reporting (OSCAR), and National Supplier Clearinghouse (NSC) when used in HIPAA standard transactions. For reference, HIPAA standard transactions are exchanges involving the transfer of health care data between two parties for specific purposes.
Why Does Your Holistic Practice Need an NPI?
Your holistic practice will need to apply for an NPI if you are a HIPAA-covered health care provider or if you bill insurance for your services. If your practice applies for enrollment, you must have an NPI. Any enrollment application without an NPI will be rejected.
An NPI also carries other benefits as well, such as simplifying electronic transmission of HIPAA standard transactions and efficient coordination of benefit transactions. However, it’s important to know that applying and receiving an NPI will not ensure you’re Medicare credentialed or replace your current insurance enrollment.
3 Options for Getting an NPI Number
Your holistic practice can get an NPI Number in one of three ways, depending on your preference.
Option 1: Apply Through a Web NPI Number Application
You can apply for an NPI through a web-based application. Visit the National Plan and Provider Enumeration System (NPPES) website. Individual providers must create a username and password through the Identity & Access Management (I&A) System, and log in to NPPES using that username and password.
Option 2: Apply Through a Mail Paper Application
You can complete, sign, and mail a copy of the application (Form CMS-10114, “NPI Application/Update Form”) to obtain an NPI number to the NPI Enumerator address listed on the form. To request a hard copy application through the NPI Enumerator, call 1-800-465-3203 or TTY 1-800-692-2326, or send an email to customerservice@npienumerator.com.
Option 3: Apply Through an EFIO
The final option you can apply for an NPI would be to permit an Electronic File Interchange Organization (EFIO) to submit application data through a bulk enumeration process. For more information on this option, check out the CMS website here.
NPI Application Checklist: How to Fill out the NPI Application
Your holistic practice can use this NPI application checklist to ensure that you have all the correct information when filling out the NPI number application from the CMS.
- Reason for Submitting NPI Number Application Form
- Entity Type (Are you an individual or an organization that renders health care?)
- Identifying Information (including that of sole proprietorships and incorporated individuals)
- Organization Name(s)
- Correspondence Mailing Address Information
- Business Practice Location Information
- Medicaid Identification Number (if applicable)
- Other (Non-Medicare) Provider Identification Numbers
- Provider Taxonomy Code(s)
- Individual Practitioner’s Signature
- Authorized Official’s Signature for the Organization
- Contact Person’s Information