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HIPAASpace NPI Form Source NPI Lookup NATIONAL PROVIDER IDENTIFIER NPI FORM SECTION BASIC INFORMATION NPI Number Provider Organization Full Name Provider Organization Other Name Entity Type Replace

TAXONOMY INFORMATION B OTHER PROVIDER IDENTIFIERS WWWHIPAASPACECOM Information provided in the current document is obtained from official source and accuracy of the information provided is the sole responsibility of the healthcare provide All change

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HIPAASpace NPI Form Source NPI Lookup NATIONAL PROVIDER IDENTIFIER NPI FORM SECTION BASIC INFORMATION NPI Number Provider Organization Full Name Provider Organization Other Name Entity Type Replace






Presentation on theme: "HIPAASpace NPI Form Source NPI Lookup NATIONAL PROVIDER IDENTIFIER NPI FORM SECTION BASIC INFORMATION NPI Number Provider Organization Full Name Provider Organization Other Name Entity Type Replace"— Presentation transcript:

(NPPES) to assign these unique identifiers. NPI 1053752535 10-position all-numeric identification numberassigned by the NPS to uniquely identify a healthcare provider. Entity Type Organization Code describing the type of health care provider thatis being assigned an NPI. Codes are:&#xul00;&#xli00; ()&#x/li0;furnishes health care;&#xli00; ()individual human being that furnishes health care(for example, hospital, SNF, hospital subunit,&#x/li0;pharmacy, or HMO).&#x/ul0; Is OrganizationSubpart N The "Is the organization a subpart?" question mustbe answered. If the organization is a subpart = , theParent Organization Legal Business Name (LBN)and Parent Organization Taxpayer IdentificationNumber (TIN) fields must be completed. The ParentOrganization LBN and TIN fields can only becompleted if the answer to the subpart question isYes.Many organization health care providers who applyfor NPIs are not legal entities themselves but areparts of other organization health care providers thatare legal entities (the "parents").Here are three examples of organization health careproviders that may be considered subparts and mayapply for NPIs if so directed by their "parents":(1) The psychiatric unit in a hospital is not a legalentity but is part of the hospital (the "parent"), whichis a legal entity. The legal entity must obtain an NPI.The psychiatric unit is an example of a subpart thatcould have its own NPI if the hospital determinesthat it should.(2) A group practice that is not a sole proprietorshiphas a main location and could have other offices indifferent locations, but each office is not a separatelegal entity; instead, each office is part of thecorporation (the "parent") which is a legal entity. Theoffices are examples of subparts that could havetheir own NPIs if the main location determines thatthey should.(3) A pharmacy fills prescriptions for patients whosephysicians have prescribed medications for themand may also rent or sell durable medical equipmentto patients whose physicians have ordered suchequipment for them. Neither the pharmacy line ofbusiness nor the DME line of business representlegal entities; instead, both lines of business are partof an organization (the "parent") that is a legal entity.Each line of business represents a differentHealthcare Provider Taxonomy or area ofspecialization that often submits its own electronicclaims to health plans.The "parent"-we don't know who the parent is in thisexample-must ensure that each subpart thatsubmits its own claims to health plans has its ownNPI. Provider OrganizationName (Legal BusinessName) CASSANDRAPETERSON, DC, LLC Provide organization name (legal business nameused to file tax returns with the IRS). TheOrganization Name field allows the following specialcharacters: ampersand, apostrophe, "at" sign, colon,comma, forward slash, hyphen, left and rightparentheses, period, pound sign, quotation mark,and semi-colon. A field cannot contain all specialcharacters. Provider First LineBusiness MailingAddress 4348 WAIALAE AVE The first line mailing address of the provider beingidentified. This data element may contain the sameinformation as ''Provider first line location address''. Provider Second LineBusiness MailingAddress PMB 247 The second line mailing address of the providerbeing identified. This data element may contain thesame information as ''Provider second line locationaddress''. Provider BusinessMailing Address CityName HONOLULU The City name in the mailing address of the providerbeing identified. This data element may contain thesame information as ''Provider location address Cityname''. Provider BusinessMailing Address StateName HI The State or Province name in the mailing addressof the provider being identified. This data elementmay contain the same information as ''Providerlocation address State name''. Provider BusinessMailing AddressPostal Code 96816-5767 The postal ZIP or zone code in the mailing addressof the provider being identified. NOTE: ZIP codeplus 4-digit extension, if available. This data elementmay contain the same information as ''Providerlocation address postal code''. Provider BusinessMailing AddressCountry Code US The country code in the mailing address of theprovider being identified. This data element maycontain the same information as ''Provider locationaddress country code''. Provider BusinessMailing AddressTelephone Number 808-388-7682 The telephone number associated with mailingaddress of the provider being identified. This dataelement may contain the same information as''Provider location address telephone number''. Provider First LineBusiness PracticeLocation Address 98-1277 KAAHUMANUST The first line location address of the provider beingidentified. For providers with more than one physicallocation, this is the primary location. This addresscannot include a Post Office box. Provider Second LineBusiness PracticeLocation Address SUITE 142A The second line location address of the providerbeing identified. For providers with more than onephysical location, this is the primary location. Thisaddress cannot include a Post Office box. Provider BusinessPractice LocationAddress City Name AIEA The city name in the location address of the providerbeing identified. Provider BusinessPractice LocationAddress State Name HI The State or Province name in the location addressof the provider being identified. Provider BusinessPractice LocationAddress Postal Code 96701-5314 The postal ZIP or zone code in the location addressof the provider being identified. NOTE: ZIP codeplus 4-digit extension, if available. Provider BusinessPractice LocationAddress Country Code US The country code in the location address of theprovider being identified. Provider BusinessPractice LocationAddress TelephoneNumber 808-388-7682 The telephone number associated with the locationaddress of the provider being identified. Provider EnumerationDate 07/11/2013 The date the provider was assigned a uniqueidentifier (assigned an NPI). Last Update Date 08/23/2013 The date that a record was last updated or changed. Authorized OfficialLast Name PETERSON The last name of the person authorized to submitthe NPI application or to change NPS data for ahealth care provider. Authorized OfficialFirst Name CASSANDRA The first name of the authorized official Authorized OfficialTitle or Position MEMBER The title or position of the authorized official Authorized OfficialName Prefix Text DR. Authorized Official Name Prefix Text Authorized OfficialCredential Text D.C. Authorized Official Credential Text Authorized OfficialTelephone Number 808-388-7682 The 10-position telephone number of the authorizedofficial. Healthcare ProviderTaxonomy Code #1 111N00000X The Health Care Provider Taxonomy code is aunique alphanumeric code, ten characters in length.The code set is structured into three distinct "Levels"including Provider Type, Classification, and Area ofSpecialization. Healthcare ProviderTaxonomy 1 Chiropractor Healthcare Provider Taxonomy #1 Provider LicenseNumber 1 1230 Certain taxonomy selections will require you to enteryour license number and the state where the licensewas issued. Select Foreign Country in the state dropdown box if the license was issued outside of UnitedStates. The License Number field allows thefollowing special characters: ampersand,apostrophe, colon, comma, forward slash, hyphen,left and right parentheses, period, pound sign,quotation mark, and semi-colon. A field cannotcontain all special characters. DO NOT report theSocial Security Number (SSN), IRS IndividualTaxpayer Identification Number (ITIN) in thissection. Provider LicenseNumber State Code 1 HI Provider License Number State Code #1 Healthcare ProviderPrimary TaxonomySwitch 1 Y Primary Taxonomy:&#xul00;&#xli00; &#x/li0;Answered;&#xli00; &#x/li0;(there can be only one per NPI record);&#xli00; &#x/li0;taxonomy.&#x/ul0; Healthcare ProviderTaxonomy Group 1 193400000X SINGLESPECIALTY GROUP Healthcare Provider Taxonomy Group 1 Healthcare ProviderTaxonomy GroupDescription 1 Single Specialty Group -A business group of oneor more individualpractitioners, all of whopractice with the samearea of specialization. Healthcare Provider Taxonomy Group Description 1 NPPES National Plan & Enumeration System1-800-465-3203 (NPI Toll-Free)1-800-692-2326 (NPI TTY)NPI EnumeratorPO Box 6059Fargo, ND 58108-6059Email: customerservice@npienumerator.com http://www.hipaaspace.com.