A National Provider Identifier, or NPI, is a permanent 10-digit identifier used for covered health care providers in standard electronic transactions. The number identifies the provider record; it does not itself describe licensure, specialty, or participation with a payer.
Common NPI locations on CMS-1500
- Box 24J: Rendering provider NPI when required for the service line.
- Box 32a: Service facility location NPI when the instructions and claim situation require it.
- Box 33a: Billing provider NPI.
Other provider fields, including referring or ordering information, may also be required depending on the service and payer.
Verify an NPI
The public NPPES NPI Registry can be used to confirm the name, location, taxonomy information, and status associated with an NPI. Confirm that the provider information on the claim matches the payer’s enrollment records, not just the public registry.
Billing reminder: Payer and program requirements vary. Confirm the current instructions for the payer receiving the claim.