Q&A: Updating NPI Information

WHO is responsible for updating NPPES?

Every practitioner is responsible for updating their National Provider Identifier (NPI)-related information with the National Plan and Provider Enumeration System (NPPES).  

WHEN should NPI be updated?

Even if you are not subject to HIPAA regulations, the Centers for Medicare and Medicaid Services (CMS) encourages you to update your NPPES information so that the national NPI Registry and CMS’s monthly downloadable NPI files are up to date within 30 days of the change. 

WHY should my NPI be updated?

HealthTeam Advantage does monthly verification on all contracted providers’ NPI data. This can include, but is not limited to, active license information, taxonomy, and practicing location. 

WHAT information is required to obtain NPI for individual providers?

• Provider Name  
• Provider Date of Birth  
• Country of Birth  
• State of Birth (if Country of Birth is U.S.)  
• Provider Gender 
• SSN or other proof of identity  
• Mailing Address  
• Practice Location Address and Phone Number  
• Taxonomy (Provider Type) 
• State License Information