Frequently Asked Questions about the National Provider Identifier (NPI)

Q. What is it?

A. The NPI is the standard unique health identifier for health care providers. The NPI was federally mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). All individual healthcare providers must obtain an NPI in order to be identified in HIPAA standard healthcare transactions. All healthcare organizations including nursing homes and physician groups must also obtain at least one NPI. All providers were federally required to begin using the NPI by May 23, 2007.

Q. What does the NPI look like?

A. Your NPI is a ten-digit number that will identify you to all healthcare partners and insurers including the 1199SEIU Benefit Funds, Medicare and Medicaid.

Q.How do I get my NPI?

Apply online here.

Please retain your NPI notification, as you may need it for future use with other healthcare partners.

Q. How will the 1199SEIU Benefit Funds use my NPI?

A. Your NPI will be integrated into the 1199SEIU Benefit Funds’ systems and will be used for all your healthcare transactions.

Please Note: Your NPI will not replace your existing Fund ID number. You will use both your NPI and your Fund ID number for our claims system and all other Fund transactions.

Q. How will I benefit from the NPI?

A. The NPI will standardize your provider information nationally. It will also make it easier for you to identify healthcare transactions including claims status, referrals and eligibility inquiries. Your NPI will also simplify transactions including claims, coordination of benefits and may help save money in the long term.

Q. What will the NPI not do?

  • Guarantee reimbursement by the 1199SEIU Benefit Funds
  • Enroll providers in the 1199SEIU Benefit Funds
  • Convey personal information about the provider
  • Require providers to conduct electronic transactions, although this is the 1199SEIU Benefit Funds’ preferred method of payment transaction)

Q. Will I have to get a new NPI if I move?

A. Your NPI remains with you as long as you are in practice, even if you change jobs or geographic location.

Q. Where can I find more information?

A. Additional information on the NPI is available from CMS here.

The CMS NPI Viewlet at this site provides an overview of the NPI, a walkthrough of the NPI application process and a live link to the NPPES website.