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NPPES to assign these unique identifiers


NPI125580018110-position all-numeric identification numberassigned by the NPS to uniquely identify a healthcare providerEntity TypeIndividualCode describing the type of health care provider thatis bei

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Document on Subject : "NPPES to assign these unique identifiers"— Transcript:

1 (NPPES) to assign these unique identifie
(NPPES) to assign these unique identifiers. NPI 1255800181 10-position all-numeric identification numberassigned by the NPS to uniquely identify a healthcare provider. Entity Type Individual 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 Sole Proprietor N Indicate whether provider is a sole proprietor.&#xul00;&#xli00; ()of a business that is not incorporated; thatunincorporated business is a sole&#x/li0;proprietorship.&#xli00; owns all of the assets of the business and is solely&#x/li0;liable for all of the debts of the business.&#xli00; proprietorship and a sole proprietor; they are legally&#x/li0;a single entity: an individual.&#xli00; is an Entity type 1 (Individual) and is eligible for onlyone NPI (the sole proprietorship business is not&#x/li0;eligible for its own NPI).&#x

2 li00; be a subpart and cannot have su
li00; be a subpart and cannot have subparts. (See NPI&#x/li0;Final Rule for information about subparts.)&#xli00; &#x/li0;employees.&#xli00; proprietorship in order to protect the soleproprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's&#x/li0;EIN.&#xli00; sole proprietorships (for example, group practices,&#x/li0;pharmacies, home health agencies).&#x/ul0; Provider Last Name(Legal Name) LEWIS The last name of the provider (if an individual). If theprovider is an individual, this is the legal name. Thisname must match the name on file with the SocialSecurity Administration (SSA). In addition, the dateof birth must match that on file with SSA. (First andlast names are required for initial applications.) TheFirst, Middle, Last and Credential(s) fields allow 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.

3 Provider First Name JASU The first name
Provider First Name JASU The first name of the provider, if the provider is anindividual. Provider Middle Name JULIUS The middle name of the provider, if the provider isan individual. Provider First LineBusiness MailingAddress 24 SAINT JUDE BLVD The first line mailing address of the provider beingidentified. This data element may contain the sameinformation as ''Provider first line location address''. Provider BusinessMailing Address CityName FITCHBURG 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 MA 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 01420-2762 The postal ZIP or zone code in the mailing addressof the provider being identified. NOTE: ZIP codeplus 4-digit extension, if available. This da

4 ta elementmay contain the same informati
ta 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 First LineBusiness PracticeLocation Address 207 AUTHORITY DR 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 BusinessPractice LocationAddress City Name FITCHBURG The city name in the location address of the providerbeing identified. Provider BusinessPractice LocationAddress State Name MA The State or Province name in the location addressof the provider being identified. Provider BusinessPractice LocationAddress Postal Code 01420-6044 The postal ZIP or zone code in the location addressof the provider being identified. NOTE: ZIP codeplus 4-digit extension, if available.

5 Provider BusinessPractice LocationAddre
Provider BusinessPractice LocationAddress Country Code US The country code in the location address of theprovider being identified. Provider BusinessPractice LocationAddress TelephoneNumber 978-696-5115 The telephone number associated with the locationaddress of the provider being identified. Provider EnumerationDate 11/20/2018 The date the provider was assigned a uniqueidentifier (assigned an NPI). Last Update Date 11/20/2018 The date that a record was last updated or changed. Provider Gender Code M The code designating the provider's gender if theprovider is a person. Provider Gender Male The provider's gender if the provider is a person. Healthcare ProviderTaxonomy Code #1 376K00000X 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 Nurse's Aide Healthcare Provider Taxonomy #1 Provider LicenseNumber 1 430811 Certain taxonomy sel

6 ections will require you to enteryour li
ections 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 MA 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; 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 https://www.hipaaspace.c