HIPAA NPI Resource Center
Welcome to the NHIA member resource center on the National Provider Identifier which is a requirement of the Healthcare Insurance Portability and Accountability Act of 1996 (HIPAA).
HIPAA mandated that the Secretary of Health and Human Services (HHS) adopt a standard unique health identifier for health care providers. On January 23, 2004, the Secretary published a Final Rule that adopted the National Provider Identifier (NPI). All HIPAA covered healthcare providers, whether they are individuals or organizations, must obtain a NPI for use to identify themselves in HIPAA standard transactions such as electronic claims.
The NPI is replacing all legacy identifiers for use on electronic claims, such as Medicare National Supplier Clearinghouse (NSC) number and Unique Physician Identification Number (UPIN). HIPAA covered entities—providers and suppliers completing electronic transactions, healthcare clearinghouses, and large health plans—were originally required to use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007, but a one year contingency period (now ended) was granted by the Centers for Medicare & Medicaid Services (CMS). Small health plans must use only the NPI starting May 23, 2008.
This NHIA member resource center provides educational and reference materials available from NHIA and other sources on the HIPAA NPI, as well as information on new developments in the industry transition to NPI. Check back periodically for updates to this NHIA resource center.
Tools and Resources