National provider identifier (npi) application/update form 2025

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The document is the National Provider Identifier (NPI) Application/Update Form issued by the Department of Health and Human Services, Centers for Medicare & Medicaid Services. It outlines the process for health care providers to apply for, update, deactivate, or reactivate their NPI. The form requires detailed information about the provider's identity, entity type, addresses, and other identification numbers. It emphasizes the importance of providing accurate information to avoid delays in processing and potential issues with insurers. Additionally, it includes a certification statement regarding the accuracy of the provided information and outlines penalties for falsifying information.
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What information do I need to apply for an NPI? Reason youre submitting the application. Identifying information, including name, SSN and/or ITIN. Name of your organization, including EIN. Mailing and practice location addresses. Other provider identification numbers you have, if applicable. 10-digit provider taxonomy code.
WHEN should NPI be updated? Even if you are not subject to HIPAA regulations, the Centers for Medicare and Medicaid Services encourages you to keep your NPPES information updated so that the national NPI Registry and CMS monthly downloadable NPI files are up to date within 30 days of the change.
My NPI can be stolen and used by other providers. Identity thieves could not use an NPI to bill insurers unless they had all of the other information and had enrolled in Medicare or the health plan. To help prevent fraud, update all enrollment accounts when your practice location or your employer changes.
Enumeration Date, Last Updated Date, and Certification Date: The enumeration date is the day the NPI number was assigned. The last updated date reflects when the NPI profile was last updated. The certification date will reflect the date of the most recently updated certification in the NPI profile.
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. Are you looking for your first physician job?

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CMS 10114. Form Title. NATIONAL PROVIDER IDENTIFIER (NPI) APPLICATION/UPDATE FORM.
As CMS explains, a providers NPI is meant to be a lasting identifier, and is expected to remain unchanged even if a health care provider changes his or her name, address, provider taxonomy, or other information that was furnished as part of the original NPI application process.
The NPI is a 10-digit number that will be used to identify you to your health care partners, including all payers, in all HIPAA standard transactions.

npi number name change

NATIONAL PROVIDER IDENTIFIER (NPI) APPLICATION/

May 30, 2007 I agree to notify the NPI. Enumerator of any changes in this form within 30 days of the effective date of the change. I have read and

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Medicare

- National Provider Identifier. NPR. - Notice of Program Reimbursement. OBRA List each physician using an individual identifier (not the physicians name, NPI

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