GET IT, SHARE IT, USE IT
To apply for NPI go to
https://nppes.cms.hhs.gov. If you already have an NPI,
please update your information with Texas Children’s Health Plan
by faxing to 832-825-8750.
Background
information
The Health Insurance Portability
and Accountability Act of 1996 requires all covered entities
(for example, providers, clearinghouses and large health plans)
begin using National Provider Identifiers (NPI) on standard
health care transactions. The purpose of the NPI is to uniquely
identify a health care provider in standard transactions, such
as health care claims.
How to apply for an NPI
To apply for an NPI, a provider may
do one of the following:
-
Visit the Web site at
https://nppes.cms.hhs.gov and complete a Web
application.
-
Call the NPI Enumerator Call
Center at
1-800-465-3203 and request a paper application. The paper
application can be mailed to:
PO Box 6059
Fargo, ND 58108-6059
-
A Provider may also call the
NPI Enumerator at
1-800-465-3203 or TTY 1-800-692-2326 for any questions
regarding the application or email at
customerservice@npienumerator.com.
Remember there is no cost to apply
for an NPI.
How to attest
your NPI
All Medicaid providers must attest
their NPI data for each of their current Texas Provider
Identifiers (TPI) to TMHP. If an NPI number is not
reported/attested to TMHP, claims will be denied. A provider can
attest an NPI by one of the following:
NPI only on EDI
claims
On July 30, 2007, Texas Children’s Health Plan will accept NPI
only on EDI claims. Paper claims must continue to have both NPI
and TPI numbers.
NPI NUMBERS ARE
DUE IMMEDIATELY
No NPI + No Attestation = No Pay.
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