The NPI is here. The NPI is now. Are you using it?
By: Mark Vogel
CMS Announces the Date by which Updates/Changes/Deletions Must Be Submitted to NPPES in Order to be Reflected in Initial Downloadable File.
The Centers for Medicare & Medicaid Services (CMS) will be disseminating provider information contained in the National Plan and Provider Enumeration System (NPPES) that is required to be disclosed under the Freedom of Information Act (FOIA), in accordance with the NPPES Data Dissemination Notice (CMS-6060-N) that was published in the Federal Register on May 30, 2007. The Notice encouraged providers who have been assigned National Provider Identifiers (NPIs) to view their NPPES data and to update, change, or delete (where permitted) the data that will be disclosed under the FOIA.
NPPES FOIA-disclosable data will be made available in an initial file that can be downloaded from the Internet, as well as in a query-only database known as the NPI Registry. There will be monthly update files that will also be downloadable from the Internet. CMS will begin disseminating data on August 1, 2007.
CMS has made available a document that will assist providers in making updates, changes, and deletions to the FOIA-disclosable NPPES provider data. The document is entitled, “National Plan and Provider Enumeration System (NPPES) Data Elements – Data Dissemination – Information for Providers” available at http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPPES_FOIA_Data%20Elements
_062007.pdf on the NPI website. We strongly recommend that providers read this document as soon as possible.
The initial downloadable file will be created using a “snapshot” of the NPPES FOIA-disclosable provider data as of a specific date. Because the initial downloadable file will be the foundation containing the FOIA-disclosable data for more than 2.2 million providers, it is important that the information in that file be as accurate as possible. In order for providers’ updates, changes, and deletions to be reflected in the initial downloadable file, providers must ensure that their updates, changes, and deletions are submitted to NPPES no later than July 16, 2007. To ensure the inclusion of updates, changes, and deletions in the initial downloadable file, July 16 is the last date on which they may be submitted via the web-based process, and is the last date by which the NPI Enumerator can receive them on the paper NPI Application/Update form (CMS-10114).[1]
There will undoubtedly be some updates, changes, and deletions that will require action on the part of the NPI Enumerator. For example, a change may be missing some required data. As a result, the change cannot be made until the NPI Enumerator has contacted the provider and obtained the missing data, enabling the change to be successfully processed and reflected in NPPES and then in the initial downloadable file. The July 16 date allows a period of time for this type of NPI Enumerator intervention, if necessary.
Updates, changes, and deletions that are submitted after July 16 will be reflected in the appropriate monthly update file, also downloadable from the Internet. For example, an update submitted on July 26 would be effective after the creation of the initial downloadable file and thus would be reflected in the first update file (to be created 1 month after the creation of the initial downloadable file); an update submitted on August 30 would be effective after the creation of the first update file and thus would be reflected in the second update file (to be created 1 month after the creation of the first monthly update file).
After the initial downloadable file is made available, an update file will be available each month thereafter at the same Internet location. All of the files (the initial file and the update files) will remain available for download at that Internet location.
The NPI Registry will operate in a real-time environment. Updates, changes, and deletions will be reflected in the NPI Registry at the same time they are reflected in NPPES. Therefore, the July 16 date is insignificant with respect to the data in the NPI Registry.
Still Confused?
Not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found at the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website. Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203.
Getting an NPI is free - not having one can be costly.
As published in the Fall 2007 PSPA Newsletter