The National Provider Identifier (May 2006)

May 2006 pages 10-11 Coding Communication:The National Provider Identifier The Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandated that the Secretary of Health and Human Services (HHS) adopt a standard unique health identifier for health care providers. On January 23, 2004, HHS published the Final Rule that adopts the national provider identifier (NPI) as the standard unique health identifier for health care providers. The effective date of the rule is May 23, 2005, 16 months after its publication date. Health care providers may apply for their NPIs now at https://nppes.cms.hhs.gov. The compliance date for...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains the National Provider Identifier and its role in the HIPAA standards environment. It covers the federal rulemaking background, compliance timing, provider eligibility, the two NPI types, the enumeration process, and the outreach initiative designed to support implementation. It is relevant for billing professionals, compliance teams, providers, payers, clearinghouses, and vendors tracking administrative and transaction requirements.

Why This Topic Matters

The article helps readers understand a core provider-identification requirement that affects standard transactions, enrollment, and operational readiness across the health care industry.

Article Sections

  1. May 2006 pages 10-11

    A brief publication header identifying the issue and page range covered by the article.

What You Will Learn

  • The HIPAA context for the National Provider Identifier
  • The general implementation timeline for NPI adoption
  • How provider enumeration is organized and administered
  • Which organizations and stakeholders are involved in outreach and education
  • What categories of providers are affected by NPI requirements

Who Should Read This

  • Medical coders
  • Billing and reimbursement staff
  • Compliance professionals
  • Health care providers
  • Payers
  • Clearinghouses
  • Vendors

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