While a grace period (contingency period) has been granted for the sole utilization of the NPI number (both the legacy and NPI numbers will continue to be recognized on claims), it is not indefinite and is only a stop-gap to prevent massive claim denials due to a 'no fault' filing on one of the two parties in a claims transaction (one party has a valid and functioning NPI and the other party does not). Please note: You must obtain your NPI by May 23, 2007. The contingency only involves the complications of successful transmission...you should be talking and working with your vendors and payers to assure proper transmission.

Testing of the paired numbers has revealed unique as well as common problems; one such problem is the lack of EXACT name replication on the approved NPI number profile and the name utilized by the IRS. Yes, EXACT! That means you should examine an official document/communication (e.g. tax coupons, notices, etc.) from the IRS and note how it has listed your Tax Identification Name TIN/EIN). It appears that the IRS does not include punctuation such as commas, periods, etc. typically used for accepted abbreviations (e.g. Inc., P.C., L.L.C., etc). If they do not match exactly your claims will be denied when you fly solo with the NPI number. So, check your NPI profile and make any needed changes. Example: State registered Corporate Articles of Incorporation and stock certificates read: Business & Clinical Management Services, Inc. but the TIN from IRS reads Business & Clinical Management Services Inc without the comma and period. If you note a difference when you compare your items you will need to edit your NPI profile on the NPI website (see procedure below).

In settings that require both a group number and a provider number on the claim such as for Medicare, Blue Cross/Blue Shield, etc., you must have both an NPI for the group and an NPI for each physical and occupational therapist. The individual provider number will be tied to the group number in order for the claim to be paid properly to the group. Even though there is a tie-in, the individual number is "owned" by the provider and will travel with him/her for the duration of his/her billing provider career. 

To obtain a group and/or a health care provider NPI go to:

• Go to this link
• Choose National Provider Identifier
• Choose apply on-line (don't forget to review the TIPS listed for profile data needed for the application)
• Document your username, your password and secret code and secure it in a safe place
• Make a copy of the tracking number you are given when you successfully complete the application and save it for future tracking until you receive a printed or electronic notice of your NPI from NPPES
• Make a copy of the official notice and secure it

To edit your NPI profile:

• Go to this link
• Choose National Provider Identifier
• Choose View or Update your NPI date
• Choose Login
• Enter your NPI User ID (this cannot be edited)
• Enter your password (and secret code if requested)
• Review the ENTIRE profile posted not just the Group Name...errors do occur
• Choose View/Modify NPI data
• Make necessary modifications
• Print screen changes and secure document

 Resource Link:

National Provider Identification Contingency Plan

National Provider Identification Number (NPI):

5-21-07