National Provider Identifier (NPI)

A unique 10-digit identification number assigned to healthcare providers by the Centers for Medicare & Medicaid Services (CMS) in the United States, facilitating standardized identification in healthcare transactions.

 

Healthcare Provider:

An individual or organization that delivers healthcare services, including physicians, nurses, hospitals, clinics, and other entities involved in patient care.

 

CMS (Centers for Medicare & Medicaid Services):

A federal agency within the United States Department of Health and Human Services responsible for administering the nation’s major healthcare programs, including Medicare and Medicaid.

 

HIPAA (Health Insurance Portability and Accountability Act):

Federal legislation that includes provisions for the standardization and protection of electronic healthcare transactions and patient health information, influencing the implementation of the NPI standard.

 

NPI Enumerator:

The organization designated by CMS to assign and manage National Provider Identifiers (NPIs) to healthcare providers and organizations.

 

Individual Provider:

A healthcare provider who is an individual person, such as a physician, nurse practitioner, or therapist, eligible to obtain an individual NPI.

 

Entity Provider:

A healthcare provider that is an organization, such as a hospital, clinic, or group practice, eligible to obtain an organizational NPI.

 

Type 1 NPI:

An NPI assigned to an individual healthcare provider, linking the identifier to the specific person and their professional activities.

 

Type 2 NPI:

An NPI assigned to an organizational healthcare provider, associating the identifier with the entity as a whole rather than an individual within the organization.

 

NPI Registry:

An online database maintained by the NPI Enumerator, accessible to the public and containing information about healthcare providers and their NPIs.