Who is required to apply for an NPI?
All health care providers, defined under the regulation to include dentists, are eligible to receive an NPI. However, only Covered Entities are required to obtain an NPI. A dental provider is a Covered Entity if he or she transmits electronic transactions governed by HIPAA, primarily electronic claim transactions. Dental providers who access claims information or benefits via the Internet are covered entities, and clearinghouses are also required to be able to accept and transmit the NPI by the federal compliance deadline. In addition to dentists who are considered Covered Entities, the broad definition of health care provider provided in the regulation encompasses all who provide health care services: individuals (including dental hygienists, physicians and all other practitioners) as well as organizations (such as hospitals, pharmacies, clinics and medical supply companies).
