Who should obtain an NPI?
Any health care provider or organization defined as a covered entity under HIPAA is required to obtain an NPI. Providers who transmit health care information via HIPAA standard electronic transactions are covered entities under HIPAA, whether they transmit the transactions themselves or use a vendor to transmit them. Even if you don’t send electronic transactions from your practice, an NPI may be needed to identify you in other situations, such as when another provider wants to refer a patient to you, a pharmacy needs to bill for drugs you prescribed, a hospital needs to bill for a patient you treated or admitted, or a lab needs to bill for services you ordered. You will also need an NPI if you bill Medicare on paper forms.
