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This document is used for providers to submit their NPI and associated information required by Suburban Health Organization.
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How to fill out npi provider number submission

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How to fill out NPI Provider Number Submission Form

01
Obtain a copy of the NPI Provider Number Submission Form.
02
Provide your legal name in the appropriate section.
03
Enter your Social Security Number (SSN) or Employer Identification Number (EIN).
04
Fill out your business address, including city, state, and zip code.
05
Indicate your taxonomy codes relevant to your specialty.
06
Complete the contact information for billing and correspondence.
07
Sign and date the form to validate your submission.
08
Submit the form via the specified method (mail or online submission).

Who needs NPI Provider Number Submission Form?

01
Individuals applying for a National Provider Identifier (NPI) for healthcare services.
02
Healthcare providers such as physicians, nurse practitioners, and counselors.
03
Healthcare organizations including hospitals, clinics, and group practices.
04
Billing services and administrative entities involved in healthcare billing and operations.
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People Also Ask about

The National Provider Identifier (NPI) application requires both a Business Mailing Address and Business Practice Location Address to be listed. The Business Mailing Address can be the same as the Business Practice Location Address if the provider can receive mail at the same location where he/she practices.
The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty.
The NPI is 10 digits in length and will replace health care provider identifiers in use today, including the nine-digit Medi-Cal provider number.
The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty.
Applying for an NPI is free, easy, and typically takes 20 to 30 minutes to complete. Organizations can apply online or by mail through the CMS NPI Application/Update Form page.

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The NPI Provider Number Submission Form is a document used to apply for or update a National Provider Identifier (NPI), which is a unique identification number for healthcare providers in the United States.
Healthcare providers who want to bill for services under their own name, regardless of whether they are individual practitioners or part of a group, are required to file the NPI Provider Number Submission Form.
To fill out the NPI Provider Number Submission Form, you need to provide accurate information about your personal and business details, including your personal identifier, practice location, and areas of specialization, ensuring all fields are completed as per the instructions.
The purpose of the NPI Provider Number Submission Form is to streamline the identification of healthcare providers and facilitate billing for services rendered, ensuring compliance with the Health Insurance Portability and Accountability Act (HIPAA).
The NPI Provider Number Submission Form must report information including, but not limited to, the provider's name, date of birth, Social Security number, taxonomy codes, practice address, and additional identifiers such as state license numbers.
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