Provide organization name (legal business name used to file tax returns with the IRS). Provider Organization Name (Legal Business Name) The "parent"-we don't know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. Neither the pharmacy line of business nor the DME line of business represent legal entities instead, both lines of business are part of an organization (the "parent") that is a legal entity. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity instead, each office is part of the corporation (the "parent") which is a legal entity. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. If the organization is a subpart =, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The "Is the organization a subpart?" question must be answered. 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).1 = (Person): individual human being who furnishes health care.
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Full Replica of the CMS (NPPES) NPI Record Field Nameġ0-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.Ĭode describing the type of health care provider that is being assigned an NPI. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.Reference NPI Information. The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. Our Data: Information on is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act). The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. Participating providers have signed an agreement to accept assignment for all Medicare-covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services.
This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD. Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older.
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