NPI registration & NPPES guide

Healthcare providers covered by HIPAA must obtain and use an NPI for standard transactions. Other providers may also need one for payer enrollment, ordering or referring services. Check the requirements for your profession, billing arrangement and the payers involved.

Obtaining an NPI is an early step in preparing for payer enrollment. Some providers obtain an NPI while still in training.

1. Check for an existing NPI. Search the NPI Registry before requesting a new number.
2. Set up or access your account. Follow the CMS I&A sign-in and registration instructions and configure multi-factor authentication (MFA).
3. Complete the NPI application. Sign in to NPPES, choose the appropriate entity type, and provide the required identity, practice, taxonomy and contact information. Follow the prompts to review and submit.

Quick reference guide download

An organization that provides healthcare or supplies may need a Type 2 NPI for its transactions and payer enrollment. Having an EIN alone does not determine the NPI type. A sole proprietor uses a Type 1 NPI; a separately incorporated healthcare organization may need a Type 2 NPI even when it has only one owner. Review the CMS application instructions for your entity structure.

No. Your NPI identifies you in healthcare transactions. A Medicare Provider Transaction Access Number (PTAN) is a separate enrollment identifier issued by your Medicare contractor. An NPI alone does not mean you are enrolled in Medicare.

If you have forgotten your password, use the Forgot Password option on the CMS Identity & Access Management (I&A) sign-in page and follow the current recovery instructions.

• If your account is locked, follow the recovery or unlock instructions shown on the I&A sign-in page.
• For account-access help, follow the support instructions in the CMS I&A FAQs.

If you have forgotten your user ID, use the Forgot User ID option on the CMS I&A sign-in page. Follow the identity-verification instructions and use the account-recovery support listed there if you cannot regain access.

• For account-access help, follow the support instructions in the CMS I&A FAQs.

No. An NPI identifies a healthcare provider in standard transactions. A CAQH Provider ID identifies a profile used to share credentialing information with participating organizations. Neither identifier alone confirms that a payer has approved your enrollment.

An individual NPI generally stays with the provider through changes in name, address or specialty. Keep the information in NPPES current. Organizational changes can require different treatment, so consult NPPES guidance before deciding whether to update an existing record or apply for a new organizational NPI.

Not necessarily. NPPES can associate additional practice locations with both Type 1 and Type 2 NPIs. A new location does not, by itself, establish that every practice must obtain a separate NPI. Review your organization’s structure and applicable enrollment requirements before deciding whether another organizational NPI is needed.

Yes. CMS makes selected NPI record information public, including provider names, taxonomy and business contact details. Enter accurate practice information and review the public record after changes. Use appropriate business contact information rather than a personal phone number when available.

Public record fields include:

• NPI and entity type
• Provider or legal business name
• Taxonomy and applicable provider license information
• Business mailing and practice location addresses
• Business telephone and fax numbers, when supplied
• Authorized official information for organizations
• Enumeration and last-update dates

PPS can help with initial Medicare enrollment and revalidation. Explore our enrollment services or schedule a free consultation to discuss your practice.