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This form is used to notify the Blue Cross Blue Shield of Kansas about the NPI (National Provider Identifier) for individual providers, organizations, or subparts thereof. It requires detailed information
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How to fill out provider organizational npi notification

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How to fill out Provider & Organizational NPI Notification Form

01
Obtain the Provider & Organizational NPI Notification Form.
02
Fill in the entity's legal name in the appropriate section.
03
Provide the organization's mailing address, ensuring it's accurate and current.
04
Enter the National Provider Identifier (NPI) number assigned to the entity.
05
Specify the type of entity (e.g., organization, group practice, etc.).
06
Include contact information for a designated representative.
07
Review all entered information for accuracy and completeness.
08
Sign and date the form to certify the information.
09
Submit the completed form according to the provided submission instructions.

Who needs Provider & Organizational NPI Notification Form?

01
Healthcare providers and organizations that are applying for or updating their NPI information.
02
Organizations that have undergone a change in ownership, structure, or contact information.
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People Also Ask about

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.

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The Provider & Organizational NPI Notification Form is a document used to report changes or updates related to the National Provider Identifier (NPI) for healthcare providers and organizations.
Healthcare providers and organizations that have received an NPI or are making changes to their NPI information are required to file the Provider & Organizational NPI Notification Form.
To fill out the Provider & Organizational NPI Notification Form, individuals should follow the instructions provided on the form, including entering their current NPI, any changes to their practice information, and submitting the form to the appropriate authority.
The purpose of the Provider & Organizational NPI Notification Form is to ensure that the NPI database is accurately updated with current information about providers and organizations for billing and administrative purposes.
The information that must be reported includes the provider's or organization's NPI, practice location, contact details, and any changes in business structure, ownership, or operating status.
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NPI Blue Cross Blue Shield provider information organizational NPI healthcare providers billing provider EIN taxonomy subparts notification form

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