National Provider Identification Number Guidance

The National Provider Identifier (NPI) is a federally-issued10-digit unique standard identification number that all Health Care Providers must use when submitting electronic claims effective May 23, 2008.

Electronic claims submitted without an NPI will be rejected back to the provider via their EDI clearinghouse.  Network Providers who submit claims via paper CMS 1500 or UB-04 are encouraged to include their NPI on their claims, however it is not required. 

At this time, MDwise Hoosier Alliance strongly encourages Network Providers to continue to submit claims with their MDwise Hoosier Alliance provider ID, in addition to the required NPI number.

How to Apply for Your NPI
Health care providers may apply for their NPI in one of the following ways:

1. Complete the web-based application at https://nppes.cms.hhs.gov. This process takes approximately 20 minutes to complete
2. Call the Enumerator call center at 1-800-465-3203 or TTY 1-800-692-2326 to request a paper application
3. E-mail customerservice@npienumerator.com to request a paper application
4. Request a paper application by mail:

   NPI Enumerator
   P.O. Box 6059
   Fargo, ND 58108-6059

Note: The most time-efficient method of getting an NPI is the web-based application process.

Reporting your NPI(s)
Network Providers must report their practice and individual NPIs to us in order to record them in the claims processing system.  Once the practice and individuals in the practice have obtained an NPI, the following four steps to report NPIs to MDwise Hoosier Alliance should be completed.

1. Use the submission form to report practice and individual NPIs. The submission form includes information specific to a practice, as well as a listing of individual participating practitioners at the office location. The submission form can be found in the Provider Center at http://www.hoosieralliance.org/provider/provcom/npi/shell.asp. For a printed copy, please call 1-888-961-3100.



2. Report the corresponding Primary Provider Taxonomy Code for the practice and each individual participating practitioner at the office location as reported on the NPI application(s). The Provider Taxonomy code, a 10-character alphanumeric identifier, indicates provider specialty and will assist MDwise Hoosier Alliance in verifying NPIs for Claims processing. Information on Provider taxonomy codes is available at www.wpc-edi.com/taxonomy.



3. Attach copies of NPI confirmation, issued to the practice and each individual participating practitioner at the office location, by the National Provider Identifier Enumerator. MDwise Hoosier Alliance will use the NPI confirmation for verification purposes.



4. Return the completed submission form, along with practice and individual NPI confirmations via fax to 1 (866) 426-7671or by mail:

   Attention: NPI - 2800
   MDwise Hoosier Alliance Health Plan
   200 Stevens Drive
   Philadelphia, PA  19113