E-claims must include the dentist's Type 1 NPI

What is an NPI?

It contains no inherent information about the provider, such as state of residence or license number. The federal government is also responsible for assisting providers in completing the application and resolving problems associated with an NPI. The broad definition of health care "provider" in the federal regulation encompasses all who provide health care services. Please note: Although dental assistants and hygienists are "providers" and are thus eligible to obtain an NPI, they are only required to do so if they submit claims for their services.

National Provider Identifier (NPI)

Therefore, all billing providers in Minnesota must apply for an NPI and understand the requirements for its use. In other states: Use of the NPI by providers is required for electronic claims only. Type 2: Organizations or Corporations such as hospitals and clinics — Only needed if the organization or corporation does the billing.

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You will use the NPI to designate:. This cannot be a Type 2 NPI. Billing Provider — the entity doing the billing — Use Type 1 NPI if the chief dentist does the billing for all dentists.

  • National Provider Identifier.
  • Prevent theft of your National Provider Identifier | Physicians Practice.
  • National Provider Identification (NPI) Instructions.
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  • Obtaining an NPI!
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General rules:. Practices that are sole proprietorships should not get a Type 2 NPI. The NPI will replace other identifying numbers currently used in electronic transactions, such as your:.

The NPI will not replace numbers used for purposes other than general identification, such as your:. There is no cost to apply.

NPI (National Provider Identifier) Search on Find-A-Code

You may apply for your NPI either:. Call or TTY When you apply for your NPI, you will be asked to provide your digit taxonomy code. For quick reference, here are the dental taxonomy codes:. If any of the data you submitted on your application changes, notify NPPES within 30 days of the change. Remember to notify each dental plan of your NPI separately. Please remember to continue to include your TIN and License on the claim.

Other health and dental plans may have differing timelines for NPI implementation, so take notice of each plan's requirements.

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In addition, you will want to contact your clearinghouse for instructions about their transition plans for using the NPI. NPI Enumerator. Note: The NPI number is the sole identifier for each provider and should replace each health plan identifier. Providers only need to apply for an NPI once. For the best experience on this website, please disable all pop-up blockers and use one of the following Web browsers: Internet Explorer, Safari, or Chrome.


Prevent theft of your National Provider Identifier | Physicians Practice

All rights reserved. Hospitals organizations, physician groups, nursing facilities, etc.

  1. How to Apply for your National Provider Identifier Number (NPI);
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  5. Hospitals should obtain separate NPIs for each Medicare A number for example, home health, hospice, emergency room, mental health, rehab.