How to Lookup NPI Numbers for Physicians

How to Lookup NPI Numbers for Physicians

All physicians, providers, and healthcare entities covered by the Health Insurance Portability and Accountability Act (HIPAA) must apply for a National Provider Identifier (NPI).

NPI is a distinctive identifier for insurers, health plans, prescribers, healthcare clearinghouses, business associates, and more to file or process health insurance claims as an industry standard.

What is the purpose of NPI?

It is made mandatory to have an NPI for all HIPAA covered entities and healthcare providers. It is intended to increase the health care system’s efficacy and help eliminate fraud and abuse.

CMS takes action to strengthen the Health care electronic transactions with the NPI.

How to Lookup and Verify Providers and Healthcare Organizations

NPI Registry

The NPPES NPI Registry is a free directory provided by the CMS to search for all the National Provider Identifier information that is active.

Besides an online searchable database, CMS also provides an active NPI list as a file download or an application programming interface (API).

Looking up a physician or healthcare organization on the NPPES NPI List is relatively straightforward, but when referencing any database for the first time, a slight learning curve may occur.

How to Lookup NPI Numbers for Physicians

You will need to quickly connect either an individual or an organization with which type of provider you are trying to reference for NPI validation. Next, to help provide more contexts for search results, it helps describe the taxonomy.

After you have entered all of your data, the NPI Registry will then produce a few products. CMS publishes only parts of the NPI record publicly available, including the provider’s name, the specialty (taxonomy), and the practice address.

The help finds NPI Registry for any healthcare provider, including doctor. You can search on it by group or individual name or with NPI number.

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