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National Provider Identifier (NPI) Information

  • The National Provider Identifier (NPI) is a unique identification number for health care providers that will be used by all health plans nationwide including Medicaid next year.
  • The Administrative Simplification portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires the new standard unique identifier.
  • Entities covered by HIPAA using electronic transactions must each obtain and use their unique NPI number by May 23, 2007 (examples: providers, clearinghouses, payers).
  • Providers are required to provide their NPI(s) information to all payers.
  • The North Dakota Department of Human Services, which administers the state's Medicaid program, has created a coalition to help educate providers about the NPI.

Coalition Information

Informational Meeting Dates, Locations, and Times

Providers located in the Bismarck area are welcome to join us at the location listed above. Providers outside of the Bismarck area, should e-mail dhsnpihelpdesk@nd.gov for dial-in information.

Submitting Questions: Please submit NPI related questions to dhsnpihelpdesk@nd.gov at least 24 hours prior to the meeting. Questions will be answered to the best of our ability and may require additional research.

Coalition Meeting Minutes

Fact Sheet

Frequently Asked Questions

North Dakota Department of Human Services Resources:

Other Resources

Background and application process for Health Care providers. This link illustrates the step-by-step process on how to fill out the NPI application.

Centers for Medicare and Medicaid Services (CMS) web page dedicated to NPI.

National Plan and Provider Enumeration System (NPPES). The NPI Enumerator is responsible for issuing the NPI numbers.

Electronic File Interchange (EFI), also referred to as "bulk enumeration", is a process by which a health care provider or group of providers can have a particular organization (the "EFIO") apply for National Provider Identifier(s) (NPI) on their behalf.

Noridian Mutual Insurance Company - Additional NPI information.

Centers for Medicare and Medicaid Services (CMS) Forms:

The new HCFA 1500 Form - National Uniform Claim Committee responsible for the approval of the HCFA 1500 form.

The new UB 04 Form - National Uniform Billing Committee (NUBC) responsible for the approval of the UB 04 form.

Washington Publishing Company - Organization responsible for publishing HIPAA transaction related materials.

 

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