NPI Number (Type 1 & Type 2)

Next in our steps to start a medical practice, there are two types of National Provider Identifier (NPI) numbers: Type 1 for healthcare providers, and Type 2 for organizations such as facilities, hospitals, home health agencies, labs, and durable medical equipment (DME) suppliers.

Pretty much all of us should have an individual NPI number (type 1) already. Mine was created for me during residency. You can look up your NPI hereFor whatever reason, if you do not have an individual NPI number, you can apply online at the NPPES NPI Registry. Before you apply, you first need to create a CMS Identity & Access Management System (IA&M) ID and password. You will also be using this universal login to apply for your Medicare number through the PECOS (Provider Enrollment, Chain, and Ownership System), and to attest for the old Meaningful Use with EHR which has been scrapped for MIPS (Merit-Based Incentive Payment System).  You now have to attest through your specialty’s clinical registry (IRIS registry for ophthalmology).  I’m sure you see a trend here: just as many acronyms as ophthalmology, but much more useless.

Once you have your IA&M ID, the rest is pretty easy.  If you do not have an individual NPI number yet, just click on the “Apply for an NPI number for myself” tab. Otherwise, your existing NPI information will be available under the “Manage Provider Information” section. You can edit and update your information there.  Enter as much information as you can. I used my home address as my practice location prior to acquiring my office address. P.O. boxes are not allowed.

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As for the organizational (type 2) NPI number for your practice, you won’t be able to apply until you have your tax identification number (TIN), which is also known as an employer identification number (EIN).  In order to obtain a TIN, you will need an office address first. Technically, you could probably use your home address to apply for a TIN now, but there really is no point.  You’re just introducing another element of potential delay when you have to update your real office address with the IRS later. Hence, I would wait until you sign your office lease.  We will go over how to obtain a TIN/EIN in a future post. 

You’ll be amazed how much of a rate limiting step the business address is.  Until you acquire an office space, a lot of tasks will have to be placed on hold. While I was finishing up my residency in Chicago, all I could do was obtain my California medical license, DEA number, individual NPI number, and malpractice insurance.  That was it. Everything else was waiting for me in San Jose…  😮

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