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Guide to NPI Data Fields on the revised CMS-1500 and the Electronic Claim File (837P) This document provides guidance to changes that may be required to accommodate the National Provider Identifier
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The guide to NPI data is a set of instructions and guidelines that provide information on how to collect, process, and report National Provider Identifier (NPI) data. It helps healthcare providers and organizations understand the requirements and procedures for submitting accurate and complete NPI data.
Healthcare providers, including individual practitioners and organizations, who have been assigned a National Provider Identifier (NPI), are required to file the guide to NPI data. This includes physicians, hospitals, clinics, pharmacies, nursing homes, and other entities involved in healthcare services.
To fill out the guide to NPI data, healthcare providers need to collect the relevant information about themselves or their organization, such as name, address, contact details, taxonomy code, and other identifying information. They can then refer to the guide, follow the provided instructions, and use the designated reporting system or platform to submit the necessary data.
The purpose of the guide to NPI data is to ensure consistent and accurate reporting of healthcare provider information. It helps in maintaining a standardized database of healthcare providers across different systems and organizations, facilitating coordination, identification, and verification of providers for various healthcare-related activities such as billing, claims processing, referrals, and research.
The guide to NPI data requires healthcare providers to report various information, including but not limited to their legal name, practice location address, mailing address, contact details, specialty, taxonomy code, associated group information if applicable, and any changes or updates to the provided information. The specific data fields and requirements may vary based on the provider type and the reporting system in use.
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