NPI
also known as: National Provider Identifier
The unique 10-digit number that identifies a healthcare provider in standard transactions and screening lists.
An NPI — National Provider Identifier — is the unique, 10-digit numeric identifier assigned to healthcare providers in the United States by the National Plan and Provider Enumeration System (NPPES).
Every provider who bills Medicare, Medicaid, or commercial payers has an NPI. It is the most reliable key for screening because, unlike a name, it does not change and is not shared between people. When an exclusion record carries an NPI, a screen can be matched with high confidence; when it does not, screening must fall back to name, date of birth, and address — which is more prone to false positives.
ProviderScore screens by NPI against the LEIE, SAM.gov, state Medicaid exclusion lists, state board sanctions, OFAC SDN, and FDA debarment in a single lookup.
EXAMPLE
Screening NPI 1234567890 returns a CLEAR result, meaning that identifier does not appear on any exclusion or sanction list checked.RELATED TERMS
Screen a provider against the NPI
Enter an NPI or name to check OIG LEIE, SAM.gov, state board sanctions, state Medicaid exclusions, OFAC SDN, and FDA debarment in a single lookup.
← Back to glossary · 6 terms total