What is the NPPES? NPPES stands for National Plan and Provider Enumeration System, and is the database used by NPI number holders and the Centers for Medicare and Medicaid Services. An NPI number is the unique identification code used by medical practitioners and replaced previous identification codes, such as the UPIN. It must be included in all financial transaction forms for providers working under the Medicare and Medicaid schemes.
What is the NPPES registry? The NPPES registry is simply a database that contains all of this information. You can search for medical providers and organizations to obtain any missing details when submitting a medical claim form. The NPPES registry contains details on the following kinds of medical practitioners: • • • • • • • • •
Family medicine practitioners Physician's assistants Internal medicine Nurse practitioners And more Finding details on the relevant provider is incredibly simple. You just need to enter any of the following: Name (first and/or last) Organization name NPI number
The more details you include in the search, the more accurate the results will be. Performing a reverse search using an NPI number will give you any details you might be missing, such as organization location or a provider's specialty. Searches can also be initially filtered by state, allowing you to refine them further. Results will show a practitioner or organization's name, their address and contact number, NPI number, and their specialty. This should give you all the details you need to successfully complete your form. The NPPES registry is updated regularly, but there might be several reasons you can't find the information you need. For example, there might be spelling variations for names or organizations, or the registry simply hasn't been updated since any changes were made to your practitioner or organization. The benefit of performing an NPPES lookup compared to simply knowing an NPI number is that the lookup provides you these extra details. An NPI number alone isn't enough information, as it only covers a practitioner's name. You might need the other information to submit a claim or to find a practitioner with a relevant specialty in your area. Visit our website at npi-lookup.org