Bulletin: January 23, 2004

HIPAA provider identifier finalized

By: , Compliance Officer

The Final Rule for the Provider Identifier was published in today's Federal Register

The rule establishes a standard for a unique health identifier for health care providers and announces the adoption of the National Provider Identifier (NPI) as that standard. The compliance date for implementation is 5/23/07 for providers, health plans (5/23/08 for small health plans), and clearinghouses. The NPI is a 10 position numeric identifier, with a check digit in the 10th position, and no intelligence about the health care provider in the number. The NPI is a new number that will be issued through the National Provider System, which is being developed by CMS. The NPI replaces all “legacy” identifiers that are currently being used.

Health care providers do not need to take any action to apply for NPIs at this time. The system that will handle the assignment of NPIs will be ready to accept applications for NPIs after the effective date of the final rule, which is May 23, 2005.