Npi application form 2025

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The document outlines the requirements for healthcare providers to obtain a National Provider Identifier (NPI) for participation in Florida Medicaid. It details the registration process, including necessary information to submit with the provider enrollment application, and emphasizes the importance of using the correct NPI, taxonomy, and zip code for billing. Additionally, it provides resources for further information on NPI regulations and encourages providers to stay informed about changes.

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Click ‘Get Form’ to open the NPI application form in the editor.
Begin by entering the Provider’s Name and Provider Type. Ensure that you print legibly for clarity.
If applicable, input your License Number and Provider Medicaid Number. If you do not have an NPI yet, leave that field blank.
Enter your NPI number. If you are not eligible for an NPI, indicate ‘atypical’ in this section.
Fill in the Taxonomy code and Zip + 4 fields. Remember that the Zip + 4 must be a 9-digit number.
Have the Provider or authorized agent sign the form and include the date of signing.
Finally, print the signer’s name and title to complete the application process.

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

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What is needed to apply for an NPI number?

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.

Who is responsible for NPI?

The Centers for Medicare and Medicaid Services (CMS) is responsible for oversight and management of the NPI system.

What is an NPI needed for?

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.

What does it take to get an NPI number?

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.

Who does not need an NPI?

Who does not need an NPI number? According to CMS.gov, any entity that does not meet the definition of a health care provider as defined in 45 CFR 160.103 may not apply for an NPI. This includes: Billing services.