Neurosurgeons Must Obtain National Provider Identifier Number by
May 23, 2007
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the creation of
a standard unique health identifier number for health care providers. During the last year, the
Centers for Medicare & Medicaid Services (CMS) has been issuing NPIs and, after May 23, 2007,
CMS will require a NPI number for all Medicare claims submitted.
Neurosurgeons must be in compliance by May 23, 2007 to prevent any disruption in Medicare payments. When applying for the NPI, CMS recommends including "legacy" identifiers for all payers, not only those for
Medicare. A "legacy identifier" is any provider number (e.g., BCBS, Medicare and/or Medicaid
number, etc.) other than the NPI number. Since October 1, 2006, Medicare has been accepting
claims that list only the NPI; however CMS strongly encourages providers to submit both legacy
identifiers and their NPI on claims. In addition, when reporting a Medicaid number, the state
associated with the number should be included. Finally, some private health plans may also start
using the NPI, so neurosurgeons are strongly encouraged to obtain their NPI before the May
deadline.
>Information on applying for an NPI is available on the CMS Web site at
www.cms.hhs.gov/NationalProvIdentStand/. Physicians can apply for an NPI online at https://nppes.cms.hhs.gov or can call the CMS NPI "enumerator" to request a paper application at 800/465-3203.