NPI Number Lookup: How To Find And Verify Provider Information?

Validating healthcare professionals is possible by checking their NPI numbers. The ten-digit code can tell whether the person belongs to the medical department. This identification method came into existence in 2007. Even a medical student can also register and apply for it.

This number works like a medical license for an individual. Millions of US healthcare professionals have enrolled themselves and gotten their identification numbers. For the NPI register, you can find on this site. You can easily find and verify the information regarding the healthcare provider and decide whether to visit him for your treatment.

In this write-up, you will explore more information regarding the NPI, its importance, verification, and much more. The database contains other details about the medical professional. These details are important to check to reach any medical expert for your treatment.

About Unique Ten-digit NPI Identification Number


It helps in identifying healthcare providers in different regions of the United States. Medical professionals can use this number in many ways, like pharmacy, medical aid, insurance, etc. They can do standard transactions under HIPAA policy.

The database details of an individual can change only when the individual changes his location or job. All medical professionals must get this unique identification number.

Who Requires It?

All medical professionals under the HIPAA act must enroll for this identification number. But if you are an individual practitioner or belong to any organization, you are limited to getting this ID.

In many cities in the US, medical professionals must apply for this number. It will help patients get details regarding licensed practitioners, nurses, or medical students.

Purpose of NPI Number


All types of transactions related to HIPPA policy require NPI. It is quite helpful for medical professionals to get identified by others. This unique number can be used for making transactions in the healthcare world. People can verify the details of a licensed healthcare provider before taking the treatment.

They can communicate comfortably regarding health plans and proceed with transactions. Whenever medical records are maintained, the healthcare department identifies the medical staff’s records and includes them in the records. This number is also helpful for tracking individuals involved in fraud cases. The HHS department does such identification.

Application Method

If you can get an NPI, you must apply for it immediately. It can be done online by visiting the NPPES website. It is mandatory to log in to the given national plan and proceed further with the application process. It is crucial to have an EFIO application that needs to be submitted on your behalf. The process is accomplished by the enumeration method done in bulk.

The EFIO will ask for permission, and you must agree to it. While submitting the application form, keeping a copy in your system is better. You can also update the existing details if you have already applied for it. You can make updates in the case of a job or address change.

Different Types of NPI


Whenever you fill out an application to get the NPI number, you will see two options, i.e., Type 1 and Type 2. Generally, Type 1 is for all healthcare providers who work as individual practitioners, like psychiatrists, physicians, etc. On the other hand, Type 2 is for all the medical professionals that work for an organization, group, trust, nursing home, hospital, etc.

You need to check your working status before filling out the application. When your working status changes, you need to update your details. At the time of verification, one must have accurate details. Therefore, you must take immediate action when updating any information or filing the application process.

Reasons to Verify NPI

There can be many reasons one should check and verify the NPI number of any medical professional. Such as:

  • Get complete documentation of medical experts to ensure they hold the license
  • Patients can ensure whether they will receive proper medical care or help
  • The reimbursement parties will also check before making any transaction
  • The healthcare industry must comply with the common Sunshine act
  • Helpful while aiding healthcare interactions and allowing participants to share content after proper identification
  • Easy for patients to find medical professionals near them

Method to Find and Verify NPI


Sometimes, the concept of NPI sounds complicated for healthcare professionals and patients. In the US, it has become mandatory for all medical staff to apply for this number. It is helpful for their identification and can be used in many ways. Patients can find and check the availability of medical experts near them.

They ensure they get the appropriate treatment from a certified or licensed doctor or healthcare provider. It is easy to check the validity of the NPI by using the Luhn check. The process is quite the same as you do for credit cards. According to this method, you need to take the alternate digits and double them.

Now, you need to add them with other numbers, and after that, subtract it from the rounded number close to its 10s. You can also do it by using JavaScript. To validate whether any NPI is assigned to any medical professional, you can check by NPPES API. You can easily search and find online URLs to check and validate any ID.

Final Thoughts

Nowadays, all medical professionals must get an NPI identification number. This unique 10-digit code is used everywhere in the healthcare industry. Patients can search for and validate their licenses before getting any treatment.

Before making any transactions, many people consider checking the NPI to validate an individual’s details and ensure he is the right person to participate in the medical journey. The verified person’s name is mentioned on bills, transactions, etc.

If you have not applied for the same, you must do it immediately. In the case of any update, you must go for it so that you can work and take care of patients. You must get support from everyone in the healthcare industry, and it is possible only when you have this ID.