National Provider Identifier (NPI)

What is the NPI?

The NPI is a unique, ten-digit identifier that the Centers for Medicare & Medicaid Services (CMS) issue to all health care providers as mandated by the federal government via the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The NPI eliminates the need for multiple identifiers from different health plans. All covered entities under HIPAA must obtain an NPI.

In order to bill claims successfully, complete the following steps:

  1. Obtain your NPI.
  2. Register your NPI with IBC.
  3. Enroll your NPI for electronic claims submission.

Continue reading below for more information on each step.

How to Get an NPI

Providers who need an NPI may apply for it in one of two ways:

  • Online. This is the quickest and easiest way to obtain an NPI. The online application takes approximately 20 minutes to complete.
  • By mail. Request a paper application by calling the National Provider Identifier Enumerator call center at 1-800-465-3203.

Once an NPI application has been successfully processed, the applicant will receive an NPI confirmation notice, including an automatically issued ten-digit NPI. Web applicants will receive confirmation by email; paper applicants will receive confirmation by standard mail.

Help avoid rejected claims: use a registered, valid NPI.

Register Your NPI with IBC

Our system will reject any claims submitted without a registered NPI. Avoid rejected claims by registering your NPI with Independence Blue Cross before submitting claims. Register your NPI online with IBC now.

Get more information about how to register your NPI with IBC.

Enroll Your NPI for Electronic Claims Submission

Your NPI must be affiliated with the entity that submits your electronic claims. Please contact your billing software vendor, clearinghouse vendor, or third-party billing service for instructions on how to submit an EDI enrollment request. If you are a new trading partner or already know your vendor’s trading partner number, please enroll by going to the EDI Trading Partner Business Center and completing the Provider Changes form. Please only enroll the NPI that identifies your billing group, not the individual NPIs for your practitioners.

Use a Valid NPI for All Claims

Our system reviews each claim to ensure it contains a valid NPI. To date, many claims are not passing this validation stage. Claims that fail the validation stage are automatically rejected.

Most common reasons why claims are not passing the validation stage:

  • the wrong provider identifier is entered in an NPI field;
  • the NPI is entered incorrectly;
  • the number entered is an invalid NPI.
  • the NPI is not affiliated with the submitting entity.

For more information on how to submit claims, please refer to the Claims Submission Toolkit for proper electronic and paper claims submissions.

View Independence Blue Cross’s (IBC’s) Frequently Asked Questions about NPI.

Additional NPI Resources on the Web

Important information about links to other sites