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The Health Insurance Portability and
Accountability Act of 1996 (HIPAA)
mandated that the Secretary of
Health and Human Services adopt a
standard unique health identifier
for health care providers. On
January 23, 2004, the Secretary
published a Final Rule that adopted
the National Provider Identifier (NPI)
as this identifier.
The purpose of the National Provider
Identifier (NPI) is to uniquely
identify a health care provider in
standard transactions, such as
health care claims. NPIs may also be
used to identify health care
providers in internal files to link
proprietary provider identification
numbers and other information, in
coordination of benefits between
health plans, and in other ways.
HIPAA requires that covered entities
(i.e., health plans, health care
clearinghouses, and those health
care providers who transmit any
health information in electronic
form in connection with a
transaction for which the Secretary
of Health and Human Services has
adopted a standard) use NPIs in
standard transactions by the
compliance dates.
The compliance date for all covered
entities except small health plans
is May 23, 2007; the compliance date
for small health plans is May 23,
2008. As of the compliance dates,
the NPI will be the only health care
provider identifier that can be used
for identification purposes in
standard transactions by covered
entities. |