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NPI Notification Form Facility / Group Name: PCI # : Facility Op. Cert #: Practitioner License#: Medicaid MMS#: Fidel is Facets ID#: Practitioner Name: Primary Address: Telephone Number: Group NPI.
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How to fill out npi notification form

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How to fill out the NPI notification form:

01
Start by obtaining the NPI notification form from the appropriate source, such as the National Plan and Provider Enumeration System (NPPES) website.
02
Read the instructions carefully to understand the required information and any supporting documentation needed.
03
Begin by providing your personal information, such as your name, contact details, and professional credentials.
04
Fill in the necessary information regarding your practice or organization, including the name, address, and contact information.
05
Specify the type of healthcare provider you are, whether an individual practitioner, group practice, or entity.
06
Indicate your practice's primary taxonomy code, which represents the specific healthcare services you offer.
07
Include your practice's organizational information, such as the legal business name, employer identification number (EIN), and any applicable state license information.
08
If you are an individual practitioner, provide the information about your practice location, affiliations, and any other associated healthcare providers.
09
Review the completed form for accuracy and ensure all required fields are filled out.
10
Sign and date the form to certify the accuracy of the provided information.
11
Submit the NPI notification form electronically or through mail to the NPPES or the designated organization responsible for handling NPI registrations.

Who needs the NPI notification form:

01
Healthcare providers who fulfill the criteria established by the Centers for Medicare & Medicaid Services (CMS) are required to obtain an NPI and, therefore, need to fill out the NPI notification form.
02
This includes individual practitioners, group practices, healthcare organizations, and any providers involved in the submission, payment, or processing of healthcare claims.
03
Different types of healthcare providers, including physicians, dentists, nurses, physical therapists, and other allied health professionals, all require the NPI notification form for NPI registration and enumeration.
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The NPI notification form is a document used to notify the National Provider Identifier (NPI) Enumerator of changes or updates to a healthcare provider's information.
All healthcare providers who have been assigned an NPI number are required to file the NPI notification form whenever there are changes or updates to their information.
The NPI notification form can be filled out online or by mail. Providers need to provide their NPI number, updated contact information, and any other relevant changes or updates to their practice or organization.
The purpose of the NPI notification form is to ensure that accurate and up-to-date information is maintained for healthcare providers in the NPI registry. This helps to facilitate communication, billing, and coordination of patient care.
The NPI notification form requires providers to report their NPI number, updated contact information such as address, phone number, and email, as well as any changes to their practice or organization, such as name, ownership, or specialty.
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Relevant keywords

NPI Taxonomy PFI MMIS RenderingServicing Attestation Cert undersigned Identifier Fidelis Facets specialties attest ENTIRETY Notification Medicaid Practitioner verification OPTIONAL

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