Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. The name prefix or salutation of the provider if the provider is an individual for example, Mr., Mrs., or Corporal. The first name of the provider, if the provider is an individual. A field cannot contain all special characters. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. In addition, the date of birth must match that on file with SSA. This name must match the name on file with the Social Security Administration (SSA). If the provider is an individual, this is the legal name. The last name of the provider (if an individual). Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).NPPES does not capture a sole proprietorship's EIN. Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s.A sole proprietorship may or may not have employees.(See NPI Final Rule for information about subparts.) As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).There is no difference between a sole proprietorship and a sole proprietor they are legally a single entity: an individual.In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.A sole proprietor is the sole (the only) owner of a business that is not incorporated that unincorporated business is a sole proprietorship.Indicate whether provider is a sole proprietor. 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).1 = (Person): individual human being who furnishes health care. Full Replica of the CMS (NPPES) NPI Record Field Nameġ0-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.Ĭode describing the type of health care provider that is being assigned an NPI. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.Reference NPI Information. The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. Our Data: Information on is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act). The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. Participating providers have signed an agreement to accept assignment for all Medicare-covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD. Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older.
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