May 2008 Newsletter

NPPES Updates

By: Technical Writer, TechComm Services

On April 21 2008, several updates and enhancements were implemented in the National Plan and Provider Enumeration System (NPPES). Some of these updates may impact healthcare providers' NPPES records.

One of the most important changes to the NPPES restricts applicants from entering a Social Security Number (SSN), Internal Revenue Service (IRS) Individual Taxpayer Identification Number (ITIN), or Employer Identification Number (EIN) in fields other than those specifically designed to capture these numbers. A warning message is displayed if applicants try to enter these numbers in other fields of the online application. SSNs, ITINs, or EINs purposely entered as numbers in the License Number field and the Other Provider Identification Number field will be masked.

Healthcare providers should review their NPPES records for accuracy and delete SSNs, IRS ITINs, or EINs that are masked or suppressed in their NPPES record. SSNs, IRS ITINs, and EINs belong only in their respective fields and should be removed from all other fields.

Organization healthcare providers should also verify the accuracy of the Legal Business Names (LBNs) and EINs that they reported to NPPES and make any necessary corrections. This is especially important if the provider is experiencing any Medicare claims processing issues.

CMS has published an article with detailed information on all of the NPPES updates and enhancements. This information will help healthcare providers in applying for NPIs, updating their NPPES records, and understanding the changes in NPPES. The article is available at http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPPES-Enhancements.pdf