Npi application printable 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 or update their NPI, which is a unique identifier used in standard transactions for health care services. The form requires detailed information about the provider, including personal identification details, business addresses, and certification of accuracy. It emphasizes the importance of providing complete and accurate information to avoid delays in processing and potential issues with insurers.

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Click ‘Get Form’ to open the NPI application in the editor.
Begin with Section 1: Basic Information. Indicate the reason for submitting the form by checking the appropriate box (Initial Application, Change of Information, etc.). Ensure you provide your NPI if applicable.
In Section 2: Identifying Information, fill in your full legal name and any other names used. Provide your date of birth and gender as required.
Proceed to Section 3: Business Addresses. Enter your business mailing address and primary practice location. Make sure all fields marked with an asterisk (*) are completed accurately.
Complete Section 4: Certification Statement by signing and dating the form. Remember that original signatures are required; no stamped or faxed signatures will be accepted.
Finally, provide a contact person's information in Section 5 for any follow-up questions regarding your application.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (129 Votes)
2018	4.3 Satisfied (205 Votes)
2012	4 Satisfied (24 Votes)
2008	4.3 Satisfied (255 Votes)
2007	4.1 Satisfied (35 Votes)
2005	4.3 Satisfied (72 Votes)

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Got questions?

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

How do I get a free NPI number?

How to Apply Phone: 1-800-465-3203 or TTY 1-800-692-2326. E-mail: customerservice@npienumerator.com. Mail: NPI Enumerator. 7125 Ambassador Road Suite 100. Windsor Mill, MD 21244-2751.

Does it cost money to get an NPI number?

There is no charge to get an NPI.

How long does it take to get an NPI number approved?

Providers can apply for an NPI online at or can call the NPI enumerator to request a paper application at 1-800-465-3203.

Is the NPI application free?

Applying for an NPI is free, easy, and typically takes 20 to 30 minutes to complete. Organizations can apply online or by mail through the CMS NPI Application/Update Form page.

What is required to apply for an NPI?

This online application takes fewer than 30 minutes once you have assembled the required documents such as your social security number and state license information. If you apply by mail, factor in turnaround time for processing and mailing. You must have an NPI in order to enroll in Medicare.

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