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NPI Registration Form - Easter Seals

NPI Registration Form - Easter Seals 2025

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4.9 out of 5

54 votes

The document outlines the requirements for healthcare providers to obtain a National Provider Identifier (NPI) for identification in HIPAA transactions, specifically for Florida Medicaid. It explains how to create unique crosswalks between NPIs and Medicaid provider IDs, emphasizes the importance of consistent billing practices, and provides resources for obtaining an NPI. Additionally, it includes a registration form for providers to submit their NPI information to Florida Medicaid.

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Click ‘Get Form’ to open the NPI Registration Form in the editor.
Begin by entering your Provider’s Name clearly in the designated field. Ensure that it is legible for processing.
Next, input your Provider Medicaid Number. This is essential for linking your NPI with Florida Medicaid.
In the NPI field, enter your National Provider Identifier. If you are not eligible for an NPI, indicate ‘atypical’.
If applicable, provide your Taxonomy code in the corresponding section to ensure accurate classification.
Fill in your ZIP + 4 code if relevant, as this helps in creating unique crosswalks between your NPI and Medicaid provider files.
Sign the form either as the provider or an authorized agent if submitting on behalf of a group. Include the date and print the signer’s name and title.
Once completed, submit the form via regular mail or overnight delivery to the specified addresses provided at the bottom of the form.

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Versions	Form popularity	Fillable & printable
2008	4.9 Satisfied (54 Votes)
2007	4 Satisfied (49 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I start residency without an NPI number?

Yes, you can start residency without an NPI number but residents may need an NPI number during clinical rotations, administrative tasks and for billing under supervision.

Who issues your NPI number?

Individuals or organizations apply for NPIs through the CMS National Plan and Provider Enumeration System (NPPES).

What is the easiest way to get an NPI number?

There are several ways to find your NHI number, including on: a prescription or prescription receipt. a prescription medicine bottle label. a hospital letter. an x-ray or test result. by checking your profile on the online patient portal provided by your general practice.

How long does it take to get an NPI number in Texas?

A provider who submits a properly completed electronic application could have an NPI in 10 days. The paper application process takes approximately 20 business days.

How do I get a copy of my NPI certificate?

The NPI Enumerator will provide a printed copy if providers contact them directly by phone at 800-465-3203 or TTY 800-692-2326, or providers can send an email to customerservice@npienumerator.com. Work with an Electronic File Interchange Organization (EFIO) to send application data through a bulk enumeration process.

How do I apply for a NPI number in NY?

If you have a social security number and do not have a NPI, go to , complete the application and submit. As soon as you receive your NPI number, please submit to your Program Administrator to be entered into E*Value.

How do I register for NPI?

A health care provider may apply for an NPI in one of three ways, by: (1) completing form CMS-10114 (NPI Application/Update Form) and mailing it to NPPES; (2) applying online at ; or (3) having an approved Electronic File Interchange Organization (EFIO) submit its NPI application data to

How do I get a NPI number in Texas?

To obtain your National Provider Identifier, go to or call customer service at 800.465. 3203. Questions about the status of an NPI application may be emailed to customerservice@NPIEnumerator.com.

NPI Registration Form - Easter Seals 2025

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