Friday, November 2, 2007

NPI Data Dissemination

October 2007

Attention: All Providers
NPI Data Dissemination Now Available

On September 4, 2007, the Centers for Medicare & Medicaid Services (CMS) made available access to the National Plan and Provider Enumeration System (NPPES). The data that is available includes only that health care provider data disclosable under the Freedom of Information Act (FOIA). In accordance with the e-FOIA Amendments, CMS is disclosing this data via the Internet. Data is available in two forms:

1. A query-only database, known as the NPI Registry. The NPI registry operates in a real-time environment and can be found here: UserIDs and passwords are not needed to use the NPI Registry. There is no charge to use the NPI Registry.

2. A downloadable file which will be replaced and updated each month. It can be found here: At the writing of this article, this function is not yet available. We recommend that you periodically check this link for its activation by CMS. CMS is recommending that providers view their NPI information on the NPI registry to ensure its validity.

If information regarding your NPI is incorrect, please update your information immediately. Providers can log into the NPPES website at to make corrections. For questions regarding updates, contact the NPI enumerator by email at or by phone at 1-800-465-3203.

In addition to using this database to validate your information, we recommend that you search this database in the event you need the NPI of a referring provider and the information is not otherwise available. For more information, refer to the data dissemination instructions at:

NPI – Get it! Share It! Use It! Getting one is free – Not having one can be costly!

EDS, 1-800-688-6696 or 919-851-8888

North Carolina Medicaid Bulletin October 2007

Attention: All Providers (Except Pharmacy)
Submit both NPI and Medicaid Provider Number on Claims

With the exception of Pharmacy providers who do not have the capability, N.C. Medicaid encourages providers to begin submitting immediately both the NPI and the Medicaid Provider Number on all claims. This information is needed for testing the NPI changes to MMIS.

If your software is not updated to submit the NPI number, please contact your clearinghouse or software vendor as soon as possible to obtain the appropriate updates. We are aware that the NCECS Web tool currently does not save the NPI. Updates will be made to NCECSWeb prior to NPI implementation. Please ensure that you keep the capability to submit the Medicaid Provider Number along with the NPI. N.C. Medicaid will continue to process claims using the Medicaid Provider Number until NPI is implemented.

NPI – Get it! Share It! Use It! Getting one is free – Not having one can be costly!

EDS, 1-800-688-6696 or 919-851-8888

No comments: