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The federal government requires providers who administer “medical and other health services” to obtain a National Provider Identifier (NPI) number. Certain provider types are required to have an NPI. Refer to the Provider Enrollment Screening Glossary for information on which provider types are required to have an NPI.
An NPI application requires a taxonomy code. The taxonomy codes entered in the APEP application should match those listed in the National Plan & Provider Enumeration System (NPPES).
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Term |
Definition |
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National Provider Identifier (NPI) |
A 10-digit number assigned to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The number is used for billing purposes. |
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National Plan & Provider Enumeration System (NPPES) |
A CMS database used to assign unique identifiers to health care providers and health plans. |
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Taxonomy Code |
A unique 10-character code that designates a provider’s classification and specialization. It is used when applying for a National Provider Identifier (NPI). |
Proof is collected from the National Plan & Provider Enumeration System (NPPES).
42 CFR 455.440