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Healthcare Data GlossaryProvider

NPI Number: Definition and Healthcare Context

Full name: National Provider Identifier

The National Provider Identifier (NPI) is a unique, 10-digit numeric identifier assigned to health care providers in the United States under HIPAA Administrative Simplification. Administered by CMS through NPPES, an NPI is permanent and does not change when a provider changes their name, address, or taxonomy. All HIPAA-covered health care providers must obtain an NPI for use in administrative and financial transactions, including claims, eligibility inquiries, and remittance advice.

Last updated: 2026-06-17Reviewed by: Dr. Jennifer Montecillo, MD — Gullas College of Medicine, 2019. Non-practicing medical reviewer.

How it’s used

  • CMS NPPES NPI Registry: every NPI in the public database links a provider's name, address, and taxonomy code to their unique 10-digit identifier.
  • CMS PECOS Medicare Provider Enrollment: enrollment records cross-reference NPIs against Medicare billing rights and reassignment data.
  • CMS Open Payments: physician payment disclosures are keyed to NPI, enabling financial-relationship lookups by individual provider.
  • CMS QPP MIPS: clinician performance scores are published at the NPI level, making NPI the join key between payment data and quality scores.

Frequently asked questions

What is an NPI number?
An NPI (National Provider Identifier) is a unique 10-digit number assigned by CMS to every HIPAA-covered health care provider or organization in the United States.
Who needs an NPI number?
All HIPAA-covered health care providers — physicians, nurses, dentists, pharmacists, hospitals, group practices, and others — are required to obtain an NPI for use in electronic administrative transactions.
Does an NPI number change?
No. An NPI is permanent and does not change when a provider changes their name, address, specialty, or employer.
What is the difference between a Type 1 and Type 2 NPI?
A Type 1 NPI is assigned to individual providers (persons). A Type 2 NPI is assigned to organizations such as hospitals or group practices.

Related terms

  • NPPES
  • Type 1 NPI
  • Type 2 NPI
  • Taxonomy Code
  • PECOS
  • UPIN
  • Entity Resolution

Explore in Fonteum

How Fonteum sources, resolves, and publishes data tied to this term.

  • DataNPPES provider dataset
  • PlatformEntity graph — one resolved record per provider
  • PlatformProvider data API
  • Use caseProvider data for credentialing teams
  • StudyWho is enrolled in Medicare (PECOS analysis)

Authoritative sources

  • CMS NPI Standard overview↗
  • NPPES NPI Registry (NPI lookup)↗
  • CMS: What is the NPI?↗
← All glossary terms

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Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

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Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

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