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Does a provider have to register an NPI if he is a “covering” doctor?

April 26, 2017doctor NPI Provider REGISTER

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Does a provider have to register an NPI if he is a “covering” doctor?

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The NPI must be registered with Medi-Cal if the doctor is a Medi-Cal provider. If a provider does not have a Medi-Cal provider number, they may not bill the Medi-Cal program directly so they do not have to register an NPI at this time. However, if the individual provider is a covered entity, as defined by the NPI Rule, the provider must apply for an NPI and their NPI must be included on all claims the primary provider submits to Medi-Cal for reimbursement.