National provider identifier (npi) application/update form 2026

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  1. Click ‘Get Form’ to open the national provider identifier (NPI) application/update form in the editor.
  2. Begin with Section 1, Basic Information. Indicate the reason for submitting the form by checking the appropriate box: Initial Application, Change of Information, Deactivation, or Reactivation. Ensure you provide your NPI if applicable.
  3. In Section 1B, select your entity type—either an individual or organization—and complete the relevant sections based on your choice.
  4. Proceed to Section 2 for Identifying Information. Fill in your full legal name and any other names used, along with your date of birth and gender. If you're an organization, provide the legal business name and Employer Identification Number (EIN).
  5. Complete Section 3 with your mailing address and primary practice location. This ensures that you can be contacted regarding your application.
  6. In Section 4, review and sign the Certification Statement to confirm that all information is accurate and complete.
  7. Finally, provide a contact person's information in Section 5 for any follow-up questions regarding your application.

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You must notify the enumerator of any changes within 30 days of the change. Most changes will not change your NPI number. Only rare circumstances such as fraudulent use of your NPI number will require that you be issued a new number.
A Step-by-Step Guide for Ancillary Providers. Document Purpose. This document provides guidance for ancillary providers on how to obtain a National Provider Identifier (NPI).

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