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How to apply for npi 2026

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 provides detailed instructions for health care providers to apply for, update, deactivate, or reactivate their NPI. The form requires accurate information regarding the provider's identity, entity type, addresses, and taxonomy codes. It emphasizes the importance of legibility and completeness to avoid delays in processing and issues with insurers. Additionally, it outlines penalties for falsifying information and includes a privacy statement regarding data handling.

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Click ‘Get Form’ to open the NPI application in the editor.
In Section 1, select the reason for submitting the form: Initial Application, Change of Information, Deactivation, or Reactivation. Ensure you check only one box.
Complete Section 2 by providing identifying information. For individuals, include your full legal name and date of birth. For organizations, provide the legal business name and EIN.
Fill out Section 3 with your correspondence mailing address and primary business practice location. Make sure these addresses are accurate for effective communication.
In Section 4, review the certification statement carefully. Sign and date it to confirm that all information is true and complete.
Finally, provide a contact person’s information in Section 5 who can answer any questions regarding your application.

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See more npi address change form versions

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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)