NPI and HIPAA Resources

Emergency Preparedness

Click on the map for updated emergency preparedness information

Updated January 6, 2009

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 created a number of requirements and regulations for health care providers, including National Provider Identifier (NPI) regulations.

The final rule establishing the NPI as the standard unique health provider identifier for health care providers was published in 2004 and requires all covered entities to be in compliance with its provisions by May 23, 2007, except for small health plans, which must be in compliance by May 23, 2008.

This page contains useful resources to help providers coming into compliance with HIPAA and the NPI regulations.

PAR members and associates can learn even more about HIPAA and NPI in PAR Mails and in audio conferences and other trainings throughout the year. Click on the HIPAA/Privacy & Security category for the 2007 PAR Mails to view the relevant documents and any information about upcoming trainings.

Centers for Medicare and Medicaid Services Overview
Federal Resource
When applying for your NPI, CMS urges you to include your legacy identifiers, not only for Medicare but for all payors. If reporting a Medicaid number, include the associated State name. The information on their website is critical for payors in the development of crosswalks to aid in the transition to the NPI. read more...

Centers for Medicare and Medicaid Services Educational Resources
Federal Resource
This CMS page includes downloads for the following wealth of information: NPI Training Package; NPI MLN Matters Articles; NPI Fact Sheets; NPI Tip Sheets; a CMS NPI Viewlet; NPI FAQ's; NPI PowerPoint Presentations; an NPI Question Resource Sheet; and the Who, What, When, Why & How of NPI. The CMS webpage is updated regularly. read more...

Centers for Medicare and Medicaid Services Contingency Plan for NPI
Federal Resource
The final rule establishing the NPI as the standard unique health provider identifier for health care providers was published in 2004 and requires all covered entities to be in compliance with its provisions by May 23, 2007, except for small health plans, which must be in compliance by May 23, 2008. The NPI replaces the use of proprietary and legacy provider identifiers in standard HIPAA transactions for health care providers and subparts. read more...

Centers for Medicare & Medicaid Services Atypical Provider QuickTip
Federal Resource
The Centers for Medicare & Medicaid Services (CMS) defines atypical providers as providers that do not provide health care. Atypical providers may submit HIPAA transactions, but they do not meet the HIPAA definition of a health care provider and should not receive an NPI number. The below link specifies Atypical Provider Types (PT) and Specialties and further defines who should receive an NPI number. read more...

Centers for Medicare & Medicaid Services NPI Status QuickTip
Federal and State Resource
You can now check the status of your National Provider Identifier (NPI) by logging into ePEAP.

The PA PROMISe™ Internet electronic Provider Enrollment Automation Project (ePEAP) windows provide you with the ability to electronically maintain and check the status of your provider information. read more...

Department of Public Welfare/Office of Medical Assistance Programs
State Resource
The purpose of the DPW/OMAP page is to provide information and tools to keep providers informed throughout the Department of Public Welfare's implementation of NPI. Watch for updates and additional resources in Provider Quick Tips, Medical Assistance Bulletins and Remittance Advice Banner Pages. read more...

Department of Public Welfare "What's New" NPI Webpage
State Resource
The purpose of this DPW/OMAP page is to make the public aware of the Department of Public Welfare's most recent NPI information. read more...

Department of Public Welfare NPI Contingency Plan Presentation
State Resource
The LATEST (May 2007) on where the Department of Public Welfare stands on NPI and contingencies. read more...

Department of Public Welfare NPI Contingency Plan "At A Glance"
State Resource
Following the NPI Contingency Plan announcement by CMS on Monday, April 2, 2007 the PA Department of Public Welfare (DPW) began to review options for implementing DPW's NPI Contingency plan. The information contained in the tables below is designed to provide contingency information at a glance. read more...

Department of Public Welfare/OMAP NPI Contingency Plan - Legacy Dual Strategy
State Resource
Department of Public Welfare issued a fact sheet on the JUNE 1 implementation of the National Provider Identifier (NPI) Contingency Plan - Legacy Dual Strategy. read more...

Workgroup for Electronic Data Interchange (WEDI) NPI Outreach Initiative
Related Resource
The mission of the WEDI NPIOI is to develop comprehensive education and outreach strategies, and support coordination, on the steps that organizations need to take to plan and implement the new National Provider Identifier so that the health care industry can avoid unnecessary and duplicative efforts and costs, delays, and disruptions associated with the adoption of the NPI. Their website offers helpful relevant links. read more...

PrivaPlan NPI Compliance Toolkit
Related Resource
The PrivaPlan online store offers their acclaimed PrivaPlan Associates, Inc.® National Provider Identifier (NPI) ToolKit on CD-ROM. PAR Members receive a substantial discount. read more...

PAR • 1007 North Front Street, Harrisburg, PA 17102 • par@par.net • phone 717-236-2374 • fax 717-236-5625