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According to the Department of Health and Human Services (HHS), the NPI is a national standard under the Health Insurance Portability And Accountability Act (HIPAA). The provider’s NPI is a unique identification number issued by the National Plan and Provider Enumeration System (NPPES), which is used by all health plans and health care clearinghouses when submitting HIPAA standards transactions.
The NPI is a 10-digit number that does not include information about the provider. The NPI is intended as an identification number to share with other suppliers and providers, health plans, clearinghouses, and any entity that may need it for billing purposes.
A PTAN, on the other hand, is specific to Medicare and is issued to providers upon enrollment in Medicare. Thus, to participate in Medicare, a provider needs both an NPI and a PTAN number. While a provider has only one NPI, the provider may have multiple PTAN numbers, representing enrollment through multiple practices or with multiple Medicare contractors.
An approved provider should use the NPI to bill the Medicare program and the PTAN to authenticate the provider when using MAC self-help tools. With the NPI and PTAN numbers, the provider or supplier in the Medicare program can be easily identified and transactions can be tracked.
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According to the Department of Health and Human Services (HHS), the NPI is a national standard under the Health Insurance Portability And Accountability Act (HIPAA). The provider’s NPI is a unique identification number issued by the National Plan and Provider Enumeration System (NPPES), which is used by all health plans and health care clearinghouses when submitting HIPAA standards transactions.
The NPI is a 10-digit number that does not include information about the provider. The NPI is intended as an identification number to share with other suppliers and providers, health plans, clearinghouses, and any entity that may need it for billing purposes.
A PTAN, on the other hand, is specific to Medicare and is issued to providers upon enrollment in Medicare. Thus, to participate in Medicare, a provider needs both an NPI and a PTAN number. While a provider has only one NPI, the provider may have multiple PTAN numbers, representing enrollment through multiple practices or with multiple Medicare contractors.
An approved provider should use the NPI to bill the Medicare program and the PTAN to authenticate the provider when using MAC self-help tools. With the NPI and PTAN numbers, the provider or supplier in the Medicare program can be easily identified and transactions can be tracked.
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