NPI: NPI Hard Copy and Online Registration
Updated March 28, 2007
HIPAA mandates the use of National Provider Identifier (NPIs) by providers beginning May 23, 2007. The Department of Health Care Services (DHCS) encourages providers to apply for their NPI at the National Plan and Provider Enumeration System (NPPES) Web site then register their NPI with Medi-Cal. Early NPI registration with Medi-Cal will assist providers in maintaining uninterrupted claim payments as Medi-Cal transitions from the current provider numbering system to the HIPAA-mandated NPI system.
Medi-Cal and Child Health and Disability Prevention (CHDP) providers are encouraged to use the online Web application to register their NPIs more quickly, accurately and cost-free. The online NPI registration tool became available on the Medi-Cal Web site on September 1, 2006 and may be accessed from the Register, Update or Inquire About NPIs Web page.
The registration allows Medi-Cal and CHDP providers to register one NPI for each active Medi-Cal/CHDP provider number. If a provider has both a Medi-Cal and CHDP provider number, the NPI will be automatically updated for both programs when a Medi-Cal/CHDP provider registers their NPI with Medi-Cal by using either the online NPI collection tool or the registration form.
NPIs registered with Medicare, and taxonomy codes provided in the original NPI application to NPPES, will also be collected on the registration form. NPIs for Non-Physician Medical Practitioners (NMPs) will be collected for providers who currently have NMP data on file with Medi-Cal.
The registration includes a list of agreement forms that contain the current Medi-Cal provider number. Providers can authorize the update of existing agreements on file with their NPI information by indicating the action on the registration form.
Providers With More Than One Active Medi-Cal or CHDP Number
Providers who have more than one active Medi-Cal or CHDP provider number must complete a separate registration for each existing provider number to register a single or subpart NPI. Providers may register only one NPI per provider number.
In most cases, the provider may choose to register either the same NPI or the subpart NPI to replace multiple provider numbers.
Pursuant to Code of Federal Regulations, Title 42, Section 424.57, providers of Durable Medical Equipment (DME), prosthetics, orthotics and medical supplies are required to use a separate NPI for each individual business location, in accordance with the HIPAA-NPI final rule. Medi-Cal providers subject to this provision of the final rule have yet to be determined. DHCS encourages providers to refer to future Medi-Cal Updates, or to the NPI Overview page, for a final determination on Medi-Cal requirements for this rule.
Separate “Pay-to” and “Mail-to” Addresses, Differing EFT Accounts and PINs
Medi-Cal allows providers to use separate “Pay-to” and “Mail-to” addresses, as well as differing Electronic Funds Transfer (EFT) account information and Personal Identification Numbers (PINs) for each provider number. Medi-Cal policy regarding such addresses and accounts will continue for each NPI registered.
Providers who choose to replace multiple Medi-Cal and CHDP provider numbers with one NPI must designate which Medi-Cal provider number will be the source of the various addresses, accounts and PINs that will be associated with the new NPI number. If a primary Medi-Cal or CHDP provider number is not specified for the new NPI, then the first Medi-Cal provider number on file will be replaced with the new NPI, by default, and be used to determine which addresses, accounts and PINs will be associated with that NPI.
Registering Multiple NPIs for Multiple Medi-Cal and CHDP Provider Numbers
The NPI registration form does not allow registration of more NPIs than existing Medi-Cal/CHDP provider numbers. DHCS is reviewing the NPI final rule requirements relative to accepting multiple NPIs in excess of the existing provider numbers. If your organization has more subpart NPIs than existing Medi-Cal or CHDP provider numbers, DHCS encourages you to refer to future Medi-Cal Updates or the "Register, Update or Inquire About NPIs" page for a final determination on Medi-Cal requirements for this NPI rule.
Providers Not Required to Register
In accordance with the NPI final rule, some providers are not required to register an NPI with Medi-Cal. According to DHCS’ interpretation of the final rule, as it relates to “atypical” providers, the following Medi-Cal provider types are not required to register an NPI:
- Adult Day Health Care Centers
- Blood Banks
- Christian Science Practitioners
- Multipurpose Senior Services Programs
Beginning December 1, 2006, Medi-Cal and CHDP providers may also register their NPI with DHCS using the hard copy National Provider Identifier Registration Form. Forms can also be obtained by calling the Telephone Service Center (TSC) at 1-800-541-5555, selecting language preference (option 11 for English; option 12 for Spanish), selecting option 16 from the main menu for NPI, then selecting option 18 from the sub menu.
If the hard copy NPI registration form is used, the NPPES NPI assignment letter must be attached to the completed form. The return address for the form and NPPES letter is printed on the registration form.
Note:
If you cannot view the MS Word or PDF (Portable Document Format) documents correctly, please visit the Web Tool Box to link to a download site for the appropriate reader.