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Standard Unique Health Identifier
for Health Care Providers

National Provider Identifier Standard

(as published in the Federal Register, January 23, 2004)

Regulation Effective Date: May 23, 2005

Compliance Date: May 23, 2007 for most covered entities
(May 23, 2008 for small health plans)

Healthcare providers may apply for NPIs beginning on,
but no earlier than, May 23, 2005.

Go to the National Plan and Provider Enumeration System web site

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National Identifiers -- How They
Fit into the HIPAA Puzzle

by D'Arcy Guerin Gue & Angie Atcher,
Phoenix Health Systems

  • PREAMBLE:

    1. Background
    2. Provisions of the Regulations and Discussion of Public Comments
      1. General Provisions
        1. Applicability
        2. Definition of Healthcare Provider
        3. NPI Standard Proposed Provisions (§ 142.402(a))
        4. Effective Date and Compliance Dates
        5. Implementation Specifications for Healthcare Providers, Health Plans, and Healthcare Clearinghouses
      2. Implementation of the NPI
        1. The National Provider System
        2. Health Care Provider Enumeration
        3. Approved Uses of the NPI
        4. System of Records Notice
        5. Summary of Effects on Various Entities
      3. Data
        1. NPS Data Structures
        2. Data Elements and Data Dissemination
      4. New and Revised Standards
    3. Summary of Revisions to Regulations Text
    4. Collection of Information Requirements
    5. Regulatory Impact Analysis
      1. Overall Impact
      2. Anticipated Effects
      3. Alternatives Considered Guiding Principles for Standard Selection
      4. Specific Impact of the National Provider Identifier
      5. Affected Entities

    REGULATION TEXT:


    View the Proposed Rule.


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    HIPAA Primer

    FINAL:

    Security

    Transaction
    Modifications

    Transactions

    Privacy
    (Modified 8/02)

    Privacy (Original)

    Employer ID

    Provider ID

    Enforcement

    HITS

    Electronic Medicare Claims


    PROPOSED:

    Claims Attachments

    Electronic Signature


    Schedule for Reg Publication/
    Compliance Calendar