Keeping Your NPI Record Up-To-Date
By Terry Fleming - last updated August 26, 2019
While working on a client's Medicare revalidation, we noticed that their NPI Registry information was out of date. This led us to check the registry information of some of our other clients and we found more outdated address and phone information.
A second red flag occurred at almost the same time when an insurance company informed us that they had been unable to reach one of our clients due to an old phone number on the NPI Registry.
Did you know that you are required to update your NPI information, either online or by mail, within 30 days of a change?
Is your NPI registry information up to date?
Your 10-digit National Provider Identifier (NPI) is a unique health care provider identification number issued by the Centers for Medicare and Medicaid Services (CMS) for Medicare and commercial healthcare services.1
To quickly check if your information is up-to-date, go to the NPPES Registry search page found at https://npiregistry.cms.hhs.gov/ The NPPES NPI registry is a free, searchable, directory of all active NPI records.
Enter your first name, last name and select your state. Click on the Search button. Your NPI, Name, NPI Type, Primary Practice Address, Phone and Primary Taxonomy will be displayed.
Click on the blue NPI number on the left side of the page to see the entire record.
If your information is correct, you are finished.
Updating Your NPI Record
To edit your NPI record go to the NPPES website and login. https://nppes.cms.hhs.gov/?forward=static.npistart#/
If you know your username and password, click on the "Sign In" link. If you don't remember your login, use the "Forgot User ID or Password?" link. Note: The user ID is your I&A User ID (Identity & Access) which is also used to access Pecos, EHR, as well as NPPES.2
Once you have logged into the NPPES website, scroll down the page until you see "Manage Provider Information" Your record can be found in the field below.
To edit the record, click on the yellow pencil under the "Action" column. Edit your information as needed. There are seven steps to the editing process. Click "Next" to move to the next step. Completing the final step will submit the Changes.
Updating the record may take as long as a few weeks. If after a few weeks, the updated information is not listed, you may contact the NPI enumerator at (800) 465-3203.
You may also update your NPI record on a paper form and mail the application. To download the form, http://www.cms.gov/cmsforms/downloads/CMS10114.pdf.
1Applying for an NPI from National Plan and Provider Enumeration System (NPPES) is detailed in our book, Opening A Private Practice – Putting the pieces together for the behavioral Health Professional, on page 16. (Available on Amazon)
2Creating one login account with the Identity and Access Management System allows you to access PECOS (To register for Medicare and update current enrollment), EHR (to receive incentive payments), and NPPES (to apply for and manage NPIs).