NATIONAL PROVIDER IDENTIFIER(NPI)
Simplifying administration and protecting patients' privacy
Get an NPI to submit electronic claims
A National Provider Identifier (NPI) is a unique, 10-digit number provided by the National Plan and Provider Enumeration System (NPPES) assigned to providers to simplify health care administration. NPIs must be included when submitting claims electronically, which ensures secure transactions and is in compliance with HIPAA regulations. In addition, individual states may require use of the NPI for paper claims.
To minimize potential claim processing errors and delays in payment, United Concordia encourages all dentists to obtain NPIs.
There are three basic types of NPIs available:
- Individual (entity type 1)
Includes sole proprietors providing health care services. An application for an Entity Type 1 NPI is completed using the individual dentist's social security number. Only one NPI will be allowed for an individual dentist.
- Organizations (entity type 2)
Includes group practices, professional corporations, clinics and incorporated individuals. Application for an Entity Type 2 NPI is completed using the organization's Employer Identification Number. A dental practice that is incorporated is considered an Entity Type 2, even if it employs only one dentist.
Subpart NPIs are given to components of organizations, such as affiliated sites that operate independently from the "parent organization", conduct their own HIPAA standard transactions, are certified by the State separately from the "parent" organization and must be uniquely identified in HIPAA standard transactions.
Submit your NPI to United Concordia Dental
As soon as you receive your NPI, please submit it along with your entity type (1 or 2), National Plan and Provider Enumeration System (NPPES) confirmation, your address and United Concordia Provider Number to our Provider Data Management Department.
Submit online when you Update Your Profile with your NPI Or Complete the NPI Submission Form and: