How to Register for an NPI

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of a standard unique identifier for healthcare providers to facilitate the simplification of the administration and transmission of healthcare data between providers, healthcare facilities, insurers and governmental oversight agencies. In particular, the National Provider Identifier (NPI) must be used in connection with all of the electronic transactions identified in HIPAA.

Key to this mandate was the development and implementation of the National Plan and Provider Enumeration System (NPPES) that collects identifying information on health care providers and assigns each one a NPI. The NPI is a unique 10-digit identification number and is mandated for use by:

In addition, these healthcare facilities are required to obtain an NPI:

The Importance of the NPI

The National Provider Identifier number will follow an individual throughout his healthcare career. Whether in private practice or in a group setting, their number will identify them for several purposes. In the latter case, the number is used to facilitate many activities including payor enrollment, billing and collection.

The primary benefit of the NPI is in the transfer of information from one entity to another. By uniquely identifying every provider, parties on each side of the transmission can communicate simply and efficiently. The NPI also includes a check digit in the final position to avoid keying errors. In addition, healthcare payors use the NPI to quickly double-check treatment regimens, provider privileges and insurance eligibility.

As an added bonus, the healthcare industry, as a whole, uses the information compiled in the NPI data set to examine and improve patient care as a whole. For example, the NPI data has been used to investigate referral patterns and improve their overall efficiency. In short, the use of a unique NPI for all healthcare providers and facilities has improved individual patient care, relieved providers of numerous administrative hassles and facilitated the making of payments in a timelier manner.

Registering for an NPI

The registration process is quick and easy and only requires about a dozen pieces of information for either a provider or a facility. The NPI application and relevant instructions can be found here on the NPPES website. Approval takes from 3-20 days and once the NPI is assigned, it is included on a searchable database.

Securing an NPI does not replace the required process of payor enrollment, however it is a crucial first step for any new provider or provider starting a new solo practice or multi-provider group.

Provider Credentialing


Patrick Birmingham

About the Author
Patrick Birmingham

Patrick Birmingham is General Manager and Senior Vice President for Payor Enrollment Services at symplr. As a healthcare industry veteran, Patrick has with over 23 years of experience in management and executive roles and a wide range of experience in hospital, managed care, payor and physician practice operations management. At symplr Patrick is responsible for managing operations across all our product lines – Credentialing, Provider Management and Payor Enrollment. Prior to joining symplr Patrick was Chief Operating Officer at MedKinetics, a leading SaaS provider credentialing company, and the founder of Payor Enrollment Services, the industry’s leading solution for accelerated and accurate payor enrollment. Previously, Patrick was National Director, Credentialing and Enrollment Services at HCA Inc., and Director of Managed Care at HCA Physician Services. Prior to HCA Patrick held senior roles within hospital administration, and national PPO and HMO organizations.

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