The Health Insurance Portability and Accountability Act (HIPAA) of 1996 required the adoption of a standard unique identifier called the National Provider Identifier (NPI) for health care providers. The NPI is 10 digits in length and replaces all legacy identifiers, including the nine-digit Medi-Cal provider number. The only exceptions to this requirement are “atypical” providers such as blood banks, Christian Science practitioners and Multipurpose Senior Services Program providers. These provider types are not required to register an NPI with Medi-Cal.

Research shows that some providers have not obtained and/or registered an NPI with Medi-Cal. Providers are strongly encouraged to obtain, register and use the NPI on claims and transaction services.

Providers that have not applied for an NPI may still do so at the National Plan and Provider Enumeration System (NPPES) website. As soon as providers receive their NPIs, they may register them with Medi-Cal using one of the following methods:

1. National Provider Identifier Collection (NPIC) – online system available through the “Register/ Update/ Inquire NPIs” page in the NPI area of the Medi-Cal website. The NPI area can be accessed by clicking “NPI” under “Featured” on the Medi-Cal website.
   
2. Bulk Registration Tool (BRT) – available to providers who would prefer to register a large quantity of NPIs at the same time using the NPIC online system. BRT instructions are available to review specific details and technical requirements for file submission on the “Register/ Update/ Inquire NPIs” page in the NPI area on the Medi-Cal website.
   
3. Hard copy NPI registration – the National Provider Identifier Registration Form, DHCS 6218 is available in the “Forms” area on the Medi-Cal website. Forms may also be obtained by calling the Telephone Service Center (TSC) at 1-800-541-5555 option 14.

If providers choose to submit a hard copy NPI registration form, they are required to attach a copy of the verification letter sent to them from NPPES and then send both to:

Department of Health Care Services
PRO – NPI Help Desk
Medi-Cal Fiscal Intermediary
P.O. Box 13811
Sacramento, CA 95853-9946

Rendering providers that do not have a Personal Identification Number (PIN) or Social Security Number (SSN) on file with Medi-Cal will need to submit the hardcopy DHCS 6218 form. The NPIC online system requires either one to register an NPI for your legacy provider ID/ Medi-Cal provider number. If neither of these are on file, you cannot register your NPI using NPIC.

For questions on NPI registration, please call the TSC at 1-800-541-5555 and select option 14.