National Provider Identifier (NPI): How to Get an NPI Number

In the healthcare billing process, your NPI number is one of the most important identifiers. Without a standardized 10-digit numeric identifier, whether you’re in your early career in healthcare or a qualified healthcare specialist, you’re unable to get reimbursed for the rendered services.

Throughout the guide, we will explain what a National Provider Identifier (NPI) is, why it matters in medical billing, and which doctors need it most. Furthermore, we will explain how to obtain an NPI, the process, and common mistakes to avoid when requesting one.

So, read the full blog post to the end if you want to get your payments without facing any denials or claim rejections.

What Is a National Provider Identifier (NPI)?

The National Provider Identifier (NPI) is a unique 10-digit numeric identifier assigned by the Centers for Medicare & Medicaid Services (CMS). It identifies both individual and organizational healthcare providers across the healthcare system. The NPI enables providers to submit medical claims to insurance plans, conduct electronic healthcare transactions, and streamline the overall medical billing process.

Why the NPI Was Introduced?

Before NPI was introduced, the providers often used multiple identification numbers. For example, Unique Physician Identification Number, Provider Identification Number, National Supplier Clearinghouse Number, Medicaid/Blue Cross Numbers. All these identification numbers have different purposes and are assigned by different payers, making the billing process more complicated. Further, providers need to update these identification numbers frequently when they change insurers.

That’s where the National Provider Identifier (NPI) comes in, mandated by HIPAA (the Health Insurance Portability and Accountability Act). When HIPAA mandated the NPI, it improved the billing process and helped prevent fraud and data breaches. Once assigned, an NPI generally remains the same for the provider’s lifetime, even if they change jobs or locations.

Benefits of Using an NPI Number;

The most beneficial thing about using NPI is that providers don’t need to use different numbers; it can be used for all healthcare plans across the United States.
NPI ensures that electronic health transactions are HIPAA-compliant, preventing fraud arising from different identification numbers.
Last but not least, NPIs help improve billing accuracy, reduce administrative burden and speed up the reimbursement process, while preventing denials.

Who Needs an NPI Number?

A National Provider Identifier Number (NPI) is required by all healthcare providers who submit claims electronically for payment. The NPI applies to all HIPAA-covered healthcare providers who submit electronic transactions or need to verify eligibility or pre-approvals for services/treatments, ensuring compliance throughout the revenue cycle process.

Types of National Provider Identifier (NPI)

NPI Type I: Individual providers such as physicians, nurse practitioners, nephrologists, orthopedists, or any other healthcare professional.

NPI Type II: Healthcare organizations such as nursing home centers, hospitals, kidney centers, urgent care centers, clinics, or any other firm that treats patients must have an NPI Type II to speed up the reimbursement process.

Where to Find an NPI Number (NPI Lookup Guide)

To find the NPI number of a doctor or any facility provider, you may use the official site of the NPPES NPI Registry, managed by the CMS (The Centers for Medicare & Medicaid Services). This official website is free, and anyone can use it to find the national provider identifier number.

Here is how to verify an NPI number online;

Visit the official site of the NPPES NPI Registry.
Now, fill in the essential details required for the doctor’s NPI number search, including the provider’s name or organization name, city, state, country, taxonomy, postal code, and address.
Hit the search button to find similar or exact matches based on the entered details.
Then check the findings to see whether the NPI is activated, the taxonomy (speciality number), license number and the practice address.
If an NPI appears inactive or deactivated, the provider must update their information through the NPPES system before submitting claims.

However, remember that these NPI findings don’t mean that the doctor is credentialed. And if your search returns no results, you should apply for an NPI number. Let’s see how.

How to Apply for an NPI Number?

Applying for an NPI number isn’t complicated; it’s the simple, easy steps anyone can perform. There are two methods you can use to apply for a provider or organization NPI number.

Online Application via NPPES Portal

The easiest and most approachable method for providers/organizations in 2026 is to submit an online application for an NPI number via the NPPES portal. Here’s how you can also apply for it.

Search for the NPPES website and open it.
Log in with your I&A user ID (if applicable) or create a new account.
Then complete the form with the required details, including SSN, license information, and practice address.
Now, submit the online application and save the tracking number to monitor the status continuously.
If the application gets approved, then you’ll receive your NPI number via email within 10 days.

Physical Application CMS-10114 Form

The traditional method for submitting an application for an NPI number is to use the CMS-10114 form. Here’s how to fill this form;

Go to the CMS.gov site and download the CMS-10114 form.
Then, complete the form with the required details, such as SSN, license no, practice address, EIN (for organizations), and taxonomy code.
Now, select the entity type: Type I for providers, and Type II for organizations.
Once you have completed the form, check the details again for accuracy and send it by mail to the address mentioned on the last page of the form.
If the application is approved, you will receive your NPI number via email within 15-20 business days.

Documents & Information Needed to Apply for an NPI

Document / Information	Type	Notes
Full Legal Name	Individual (Type 1)	First, middle (if applicable), and last name.
Date of Birth	Individual (Type 1)	Needed for verification of identity.
Social Security Number (SSN)	Individual (Type 1)	For individual provider identification.
Professional License Number	Individual (Type 1)	State-issued license for doctors, nurses, therapists, etc.
License Issuing State	Individual (Type 1)	The state that issued the professional license.
Business / Practice Location	Both	Physical address where services are provided.
Mailing Address	Both	Address for NPI correspondence.
Contact Information	Both	Phone number and email address.
Taxonomy Code	Both	Identifies provider specialty or area of practice.
Employer Identification Number (EIN)	Organization (Type 2)	Required for clinics, hospitals, or group practices.
Organization Details	Organization (Type 2)	Legal name, EIN, and organization type.

What Is an NPI Taxonomy Code?

An NPI taxonomy code is a 10-digit alphanumeric identifier that defines the provider’s specialty or area of expertise. These taxonomy codes are used for billing purposes, insurance claims and maintaining administrative data.

Here is the role of taxonomy code, and why it matters.

First, it helps health insurance companies understand the provider’s specialty area of expertise, which they use to determine the provider’s specialization and reimbursement eligibility.
Second, when you submit the claim form, using the taxonomy ID with NPI is essential for accurate payments.
Third, a provider can have more than one taxonomy code: a primary one for their main specialization and a secondary one for another area of expertise.

Common Mistakes Providers Make With NPIs

To optimize the revenue cycle workflow and ensure accurate, on-time payments, healthcare providers and organizations must avoid these common mistakes when assigning NPIs during claim submission.

Providers or the billing team often use incorrect NPIs, such as NPI Type I instead of Type II, leading to immediate claim rejections.
Use incorrect taxonomy codes. For example, you have multiple taxonomy codes, as you’re a physician and nephrologist as well. Using the physician taxonomy code when billing for nephrology services can lead to denials.
Use outdated or unverified provider information, such as licenses, contact details or primary location in the NPI registry.
Forgot to verify NPIs before claim submission.
Delays in updating provider information, such as the license number and practice verification, and in submitting claims with outdated information can result in lost payments.

Difference Between NPI, Tax ID, and DEA Numbers

Identifier	Purpose	Issuing Authority
NPI (National Provider Identifier)	Identifies healthcare providers in electronic healthcare transactions	Centers for Medicare & Medicaid Services
Tax Identification Number (TIN/EIN)	Used for tax reporting and payment processing	Internal Revenue Service
DEA Number	Authorizes providers to prescribe controlled substances	Drug Enforcement Administration

Frequently Asked Questions About NPI Numbers

What is an NPI number in healthcare?

In healthcare, NPI stands for the National Provider Identifier, a 10-digit numeric identifier assigned by the CMS. It helps the insurer understand the provider or organization’s specialty, practice area, contact details, and address to determine the charges for the services/treatments they deliver to patients.

What is an NPI number for a doctor?

For a doctor, it’s their gold card to get reimbursed for services and stay compliant with HIPAA, ensuring they can receive electronic health payments via EHR and EMR software.

How do I get an NPI number?

To get an NPI number, you must apply through a free CMS-created portal called the NPPES NPI registry or use a physical CMS-10114 form. By using the NPPES portal, you can submit your application within minutes by filling out the details, such as your taxonomy code, practice address and contact details. If you’re using a CMS-10114 form, download it from the official site (CMS.gov), fill it out, and submit it by mail.

How long does it take to receive an NPI number?

If you’ve applied via the NPPES portal, then it will take almost 10 days to receive an NPI number via mail; otherwise, it will take 15-20 days when submitting through the CMS-10114 form.

Is an NPI required for medical billing?

Yes, of course! Your NPI is an essential part of the medical billing process, and without it, you can’t even get enrolled with any network. So, make sure you have activated NPIs before submitting a claim to avoid claim denials or delays.

Can a provider have more than one NPI?

No, never. The CMS (Centers for Medicare & Medicaid Services) issues only one NPI to each provider or organisation, and they can use it for their lifetime. However, if the practice changes, the license number, death, or any other specific reason, it might be deactivated. In that case, you need to request reactivation, but the NPI number wouldn’t be changed.

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