About the National Provider Identifier (NPI)
Purchase and download the complete national NPI registry, formatted to be used immediately in Microsoft Access, FileMaker, SQL Server or other database program. Updated every month. September 15, 2025 is the most recent full update release date, with all 8.8 million provider records.
NPI Number Definition
The NPI (National Provider Identifier) is a 10-digit numerical, intelligence-free numeric identifier that is required of all HIPAA-covered healthcare providers. Unlike the CCN (CMS Certification Number), formerly known as the OSCAR Provider Number, used as the unique identifier for hospitals and other medical facilities, the national NPI registry numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. The NPI Final Rule, sometimes called the "NPI reg," requires that every HIPAA-covered healthcare provider must obtain and NPI number, and that the NPI must be used as the provider identifier in lieu of legacy provider identifiers in all electronic transactions, including the filing of healthinsurance claims.
The purpose of the National Provider Identifier (NPI) program is to assign a unique national identification code to all providers of health care whose services fall under HIPAA, including individuals, organizations and groups of individuals. These are physicians, nurses, nurse practitioners, dentists, optometrists, pharmacists, physical therapists, pharmacists, physician group practices, acute care hospitals, specialty hospitals, nursing homes, ambulatory care facilities, hospices, home health agencies, ambulance services, clinical labs, DME suppliers, pharmacies, and others who are covered under HIPAA.
Whether or not a provider accepts Medicare, all healthcare providers that are covered under HIPAA must apply for register for an NP number. The national NPI registry is available to find information on any HIPAA-covered healthcare provider. Doing a doctor NPI lookup, or lookup of any other kind of HIPAA-covered U.S. healthcare provider, is very easy by entering a few details, such as their taxonomy description (specialty or facility type, first and last name, name of the practice or other organization, zip code, etc.
The number is used in standard transactions by all health plans eliminating the previous system of multiple numbers for a single provider. (Take a look at included healthcare providers.)
The NPI Final rule requiring providers to be included in the data, and to update within 30 days of any change.Prior to the implementation of the NPI registry, payers assigned ID numbers to the providers and suppliers. The system was fragmented, with different health plans using different numbers, all of which had to be kept and used by the providers when filing claims. It was a maze of identifiers that included UPINs, Medicare PINs, state Medicaid numbers, provider identifiers assigned by thousands of health plans, and other identifiers—all of which were needed to disambiguate a particular provider across the healthcare system. The same number could be assigned to different providers by different health plans, causing misapplied payments, and requiring too much human intervention, raising healthcare costs.
The NPI national registry replaces that cumbersome system, and provides a means of uniquely identifying every HIPAA-covered healthcare provider. The National Provider Identifier is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA.
The Two Types of NPI Number
There are two "Entity Types" in the National Provider Identifier system. These represent individuals (Entity Type 1) and organizations (Entity Type 2). There are other distinctions between these entity types.
Type 1 NPI Number, for individuals (physicians, other clinicians and medical persons), is a one-and-done NPI number. Individual medical providers must have one, and only one, NPI number. This number follows the individual through life, whether they stay in the same practice, or change their location and specialty entirely. The information about the provider's specialty(ies) is included in the NPI application, where up to fifteen specialties may me reported. The Provider Taxonomy Code System, maintained by the National Uniform Claim Committee, is used to codify specialties. The provider's "taxonomy" is synonymous with specialty (and in the case of Type 2 organization records, facility type). The provider may change their taxonomy codes at any time in the future. Each provider is supposed to identify one taxonomy code as their "primary specialty," though a small percentage of records do not have a primary taxonomy code indicated.
About Taxonomy Codes
Provider Taxonomy Codes (specialty and facility types) are 10-character codes that are self-selected by the provider to designate their classification and specialization. The codes do not identify specific services rendered, but rather, they are related to the provider's education and training for particular specializations. Providers may report up to 15 taxonomies on their NPI record. In CarePrecise datasets, the provider's taxonomy code(s) and licenses associated with those codes are in a table that also indicates the primary taxonomy. The industry-standard Provider Taxonomy Code Set is updated annually in January with new or changed codes. Updates go into effect on April 1. Providers must update their selected taxonomy codes when they change. There are two special taxonomy codes that are used to identify practice groups – 193200000X identifies multi-specialty groups (groups having members with multiple taxonomies), and 193400000X identifies single-specialty groups (groups having members with a single taxonomy); these codes are not found in the counts shown here. Where licenses are required to be reported for a particular Taxonomy, the NPI enumeration system prompts the provider for the license number. Full details on codes may be found here.
The national NPI registry permits individual clinicians to have one or more Type 2 NPI numbers if they have formed a corporation, such as a small physician practice organized under statues for corporate business entities. However, they must also have a Type 1 NPI number for their person.
- Type 2 NPI Number, for organizations (clinics, hospitals, nursing homes, hospice agencies, etc.), differs from the Type 1 in these ways:
- Organizations may have as many Type 2 NPI Numbers as they like. Because the NPI number is primarily intended as the required identifier on healthcare claims, and organizations had many different tax numbers and other identifiers that they were using on claims in order to route reimbursements to the proper channels, the NPI registry allows multiple NPI numbers when the NPI replaced these other permitted identifiers.
- The Type 2 NPI number is not a "unique identifier," while the Type 1 NPI number is a unique identifier, simply because one organization may have any quantity of NPI numbers, while an individual may have only one. As a unique identifier, the Type 1 NPI can be used to very accurately identify one practitioner, that is, since each practitioner has one, and only one, NPI number, there is no ambiguity when the practitioner shows up in multiple databases, and on multiple claims. This is not so simple with organizations and their multiple NPI records. Unfortunately, the NPI registry does not require organizations to identify one of their NPI numbers as the "primary NPI," leaving ambiguity across multiple NPI records. For instance, let's say we have a list of organizations, each with several Type 2 NPI numbers, and we want to know which single organization entity each NPI belongs to. Because the NPI data is all hand-entered by the providers themselves, slight variations in the organization's name, address, and other information may vary slightly. "Medical Center of East Ledger County" may be the exact same medical entity as "Mary Markham Hospital," each with a different NPI number. In order to "roll up" all of an organization's NPI numbers, advanced record linkage technology must be used. The ambiguity is actually preferred by America's highly competitive medical organizations, as it makes the collection of business intelligence more difficult.
- Type 2 organizations actually have a different unique identifier, in theory. While the national NPI registry was intended to replace other healthcare registration numbers, hospitals and other medical facilities and agencies have a separate CCN number (CMS Certification Number), assigned by Medicare. Medical practice groups, like your doctor's office, have yet another unique identifier, the PAC ID (PECOS Associate Control ID). The group practice PAC ID is a unique 10-digit number assigned by PECOS (Provider, Enrollment, Chain, and Ownership System) to a group that an individual clinician works within or is employed by. The PAC ID is used to link all entity-level information, such as tax identification numbers and organizational names. However, not all of these organizations' PAC IDs are publicly available, and some do not have them at all. Yet another ambiguity issue requiring record linkage technology to crosslink with records in various datasets.
The ambiguity of organization records problematic, but the ambiguity of patient records has been a major problem for the healthcare industry. Record-linkage technology is very helpful here, in creating a "Master Patient Index" that can be queried with any of the patient's reported information, to return a single master record for that entity.
Creating the National Provider Identifier System
Also known as the National NPI Registry, or simply the NPI Registry, the system was implemented in May of 2005, and all HIPAA-covered providers were required to be registered (also known as "enumerated") by May of 2007. The Administrative Simplifications program of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandates use of the NPI. The system became fully operational in October 2006, when the Centers of Medicare and Medicaid Services (CMS) began issuing NPI numbers to all HIPAA-covered healthcare providers. Minor tweaks to the system have improved functionality over time, and a few significant additions have expanded its usefulness, including the addition of multiple secondary practice locations and phone numbers per provider.
A work group consisting of representatives from the private sector, Federal and State agencies came together in 1993 to define the NPI and establish a system for assigning the numbers to every U.S. HIPAA-covered entity. They developed the National Plan and Provider Enumeration System (NPPES) to operate as the central database for the NPI. While the word "Plan" in the system's name would imply that health plans are also included in the data, this extension of the system has not yet materialized.
As outlined in the Federal Regulation, The Health Insurance Portability and Accountability Act of 1996 (HIPAA), covered providers must also share their NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes. The NPI is not a protected number like the Social Security Number, and may not be hidden from public view. The national NPI registry is freely available and can be searched online.
Applying for an NPI Number
Download the national NPI registry information booklet...Providers must apply for their NPI number (a process called "enumeration"), which is generally accomplished using an online tool provided by the Centers for Medicare and Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services (HHS). Information supplied by the provider is kept in the National Plan and Provider Enumeration System (NPPES) database. Information includes in-depth contact information, specifics regarding the provider's practice or facility, and other identifying codes such as Medicare and Medicaid identification numbers and the deprecated UPIN.
Providers may choose to use a written form that can be submitted by mail. Download the NPI enumeration form to review the kinds of information collected in the NPPES database. The current database includes more than 8.8 million records.
The national NPI registry does not include a provider's PECOS status (enrollment to bill Medicare), or whether or not the provider is on the federal List of Excluded Individuals/Entities (LEIE) from the HHS Office of Inspector General (OIG); however, CarePrecise compiles this information into the CarePrecise Access and CarePrecise Select database products. The NPPES database, as released by CMS, is of a size and format that is not ready for use on ordinary computers in standard office software, such as Microsoft Office® products; CarePrecise makes the complete NPPES data, along with added information from PECOS, LEIE and other sources, available for such use.
Who Can/Must Get an NPI Number?
All individuals and organizations that are covered under HIPAA and meet the definition of covered entities (except for those listed below as being unable to register for an NPI number) can and must get an NPI number, Examples of healthcare providers who are or may be HIPAA-covered entities and must enumerate in the NPI system if they or some one else on their behalf transmits any health data in connection with a transaction for which the Secretary of health and Human Services has adopted a standard that requires them (such as on health insurance claims or prescriptions):
Individuals (Type 1 NPI Number):
- Chiropractors
- Dentists
- Midwives
- Nurses
- Opticians
- Optometrists
- Pharmacists and Pharmacy Techs
- Physical/Occupational Therapists
- Physicians
- Psychologists
Organizations:
- Ambulance Companies
- Clinics
- Group Practices
- Health Maintenance Organizations (HMOs)
- Home Health Agencies (HHAs)
- Hospitals
- Laboratories
- Nursing Homes
- Pharmacies
- Residential Treatment Centers
- Suppliers of Durable Medical Equipment (DME)
These are just examples of the kinds of providers who must get an NPI number. Refer to the definitions for the full information. These entities must get an NPI number whether or not they participate in Medicare.
Who Cannot Get an NPI Number?
Any entity that does not meet the definition of a health care provider as defined in the regulation, section 45 CFR 160.103 (provider definitions) are not permitted to apply for an NPI. Such entities include:
- Billing services
- Value-added networks
- Repricers
- Health plans
- Health care clearinghouses
- Non-emergency transportation services
Common Uses of NPI Records
In addition to its required use in claims transactions, the NPI number may be used in other ways:
- By healthcare providers to identify one another in medical activities and correspondence
- By healthcare providers on prescriptions (but note that the NPI does not substitute for the DEA number or state license number)
- By health plans in their internal provider files to process transactions and communicate with healthcare providers
- By health plans to coordinate benefits with other health plans
- By healthcare clearinghouses in their internal files to create and process standard transactions and to communicate with healthcare providers and health plans
- By electronic patient record systems to identify treating healthcare providers in patient medical records
- By the Department of Health and Human Services to cross reference healthcare providers in fraud and abuse files and other program integrity files
- For any other lawful activity requiring individual identification of healthcare providers, including use by commercial businesses, such as marketers who may use the number as an identifier for prospects and customers.
- Because the number is constructed of an even distribution of digits, the NPI number can be used to evenly divide a list of healthcare providers. For example, to divide a list of 10,000 NPI records into 10 approximately equal separate lists, the final digit (least significant digit), can be used as a key, with 0 through 9 representing approximately one-tenth of the full list.
It is important to point out that data submitted to the national NPI registry will be made public, and will remain public as long as the provider continues to be required to have an NPI number. Excluded from public access are tax identification numbers and birth dates; however, name, address, phone and fax numbers, specialties, facility types, and license numbers, among other data, are always public and freely available. Providers are not permitted to "opt out" of the national NPI registry, or the freely downloadable NPPES database.
The NPI database is a useful tool in the tracking of healthcare providers who bill Medicare, and has been helpful to law enforcement in the investigation of Medicare fraud.
Accuracy of NPI Data
CarePrecise uses the national NPI Registry (NPPES) data as one of its primary sources because of the comprehensive nature of the data. By law, every HIPAA-covered U.S. healthcare provider must be in this database, and as stated in the law, "Covered health care providers must communicate to the NPS any changes in their required data elements within 30 days of the change." The penalty for false information is severe:
18 U.S.C. 1001 authorizes criminal penalties against an individual who in any matter within the jurisdiction of any department or agency of the United States knowingly or willfully falsifies, conceals, or covers up by any trick, scheme or device a material fact, or makes any false, fictitious or fraudulent statements or representations, or makes any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry. Individual offenders are subject to fines of up to $250,000 and imprisonment for up to five years. Offenders that are organizations are subject to fines of up to $500,000. 18 U.S.C. 3571(d) also authorizes fines of up to twice the gross gain derived by the offender if it is greater than the amount specifically authorized by the sentencing.
"Penalties for Falsifying Information" section of the HHS NPI registration information publication.
In a study conducted by Mathematica Policy Research and published in the Journal of General Medicine, investigators found that the national NPI registry (NPPES database) scored best at 94% accuracy, the SK&A (now part of IQVIA) at 92%, while the AMA Masterfile had significantly lower rates of correct address information across all specialties scoring only 54%.
"NPPES and SK&A had the highest rates of matching mailing address information, while the AMA Masterfile had low rates compared with the NPPES... the NPPES and to a lesser extent, the SK&A file, appear to provide reasonably accurate, up-to-date address information for physicians billing public and [private] insurers."
"The Results Are Only as Good as the Sample: Assessing Three National Physician Sampling Frames," Journal of General Internal Medicine. 2015. Catherine M. DesRoches, Dr.P.H., et al.
Providers have learned that keeping their NPI data up to date can shorten reimbursement cycles, and improve relationships with payers as well as consumers of healthcare.
Read more about accuracy comparisons and improvements in provider data accuracy here...
When Do Medical Students Get Their NPI Numbers?
All health care providers are eligible for NPIs and may apply for them and become listed in the national NPI registry. Because medical students, interns, residents and fellow are healthcare providers, they are eligible for NPI registration and an NPI number. If they do not transmit any health data in connection with a transaction for which the Secretary of health and Human Services has adopted a standard, they are not "covered" healthcare providers under HIPAA and are not required by the NPI Final Rule to obtain NPIs. If they do, however, they would be covered healthcare providers and they must get NPIs.
If interns or residents prescribe medications for patients whose prescriptions are filled by pharmacies, refer patients to other healthcare providers, or order test for patients from other healthcare providers, those pharmacies and other healthcare providers will need to identify them as prescribers or as providers who referred patients or who ordered tests for patients in the claims transactions that they submit to health plans. Health plans may require that the NPI be used in those claims to identify the prescriber, the referring provider, and the ordering provider. Therefore, while the NPI Final Rule might not require these providers to obtain NPIs, it may be necessary for them to have NPIs in order for the pharmacies and other providers to be reimbursed by health plans.
Basically, all students need the "student" NPI number, so identified by the Provider Taxonomy Code 390200000X, Student in an organized healthcare education/training program towards a medical degree. Then, when the student becomes a healthcare provider, as described above, they are required to update their NPI record with the Taxonomy Code appropriate for the type of medicine that they now practice.
Questions About the NPI
Almost everything there is to know about the national NPI registry is here.
CMS provides a free NPI search tool for looking up providers' NPI numbers.
CarePrecise provides a listing of the data fields from the NPPES (the national NPI registry downloadable database) that are included in CarePrecise healthcare provider data products.
CarePrecise cannot access or edit NPI registry records. To update your record, as required within 30 days of any change, visit the NPPES website and login using the credentials that were created with the NPI registration.
Updating Your NPI Record
At any time, a provider, or someone acting on their behalf, may edit their national NPI registry record(s) by going to https://nppes.cms.hhs.gov, or by obtaining a paper NPI Application/Update Form (CMS-10114) from the CMS forms page (/Medicare/CMS-Forms/CMS-Forms) and mailing the completed, signed form to the NPI Enumerator. Providers who need assistance in editing their records can contact the NPI Enumerator by phone at 1-800-465-3203, by email customerservice@npienumerator.com, or by letter: NPI Enumerator, 7125 Ambassador Rd, Suite 100, Windsor Mill, MD 21244-2751.
The information disclosed on the NPI Registry and in the downloadable files are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to ‘opt out’ or ‘suppress’ the NPPES record data for health care providers with active NPIs.
CarePrecise cannot assist in NPI registry matters.
Obtaining the NPI Database
Download a listing of all of the data fields offered by CarePrecise from the NPI database (National Plan and Provider Enumeration System - NPPES) and some other sources, as part of the CarePrecise Complete data package.
CarePrecise also offers expanded datasets that include more information than is available in the NPPES, including practice group and hospital affiliations.
Email addresses for healthcare providers, acquired from many medical journals, conferences, and other authoritative sources and verified monthly, is available at the CP Preferred Email® section of our website.
The National Plan and Provider Enumeration System database (NPPES) contains the complete listing of all U.S. healthcare providers who are covered under HIPAA, both individual clinicians and organizations, such as hospitals, practice groups, home health agencies, and so on. It contains all of the publicly-sharable information in the national NPI registry The NPPES is a 10GB database that is far too large to import into Excel and most other ordinary office software. CarePrecise uses data normalization and minimization techniques to make all of that data available, but in a form that is easy to handle on ordinary office computers, using nothing more complicated than Microsoft Access, part of the Microsoft Office 365 suite.
Review CarePrecise Complete for the full NPI database, with all of the data from the NPPES database, plus added data from related federal healthcare provider databases.
CarePrecise Gold and CarePrecise Platinum both offer the complete database, plus special tools for segmenting providers by specialty, geographic radius, wealth, urban/rural, and other parameters. Platinum contains additional extended data.
The NPI data can be obtained for individual states; see CarePrecise State.
Historical NPI data is also available from CarePrecise, with its archive of both complete NPPES dissemination files from CMS, and the CarePrecise data packages, ready for use. Approximately 200 monthly datasets are available, with provider data going back to 2005. Contact us for details on purchasing historical physician data and historical data on all U.S. healthcare providers, from the NPI data as well as other authoritative sources.
Additional Resources
Refer to the CMS field descriptions for technical descriptions of the data fields. CarePrecise uses abbreviated field names.
Refer to the CMS field codes document for details on field codes used in CarePrecise.
CarePrecise Complete - Full U.S. healthcare provider database, updated monthly.
CarePrecise State - State by state healthcare provider data, updated monthly.
CP Select Hygiene - Service that provides enriched data for clients' in-house databases.
CP Select Plus - Custom databases. Permits clients to select specific provider specialties and facilities in particular geographic areas, and many other selection criteria.
CP ListMaker - Desktop application that allows clients to create highly targeted lists of providers for industry research, clinical trial development and marketing applications, using the CarePrecise Complete data. It is also available bundled with the data.
Get the full NPI Registry Database, Ready to Use
CarePrecise offers the full FOIA-permissioned NPI Registry database, ready to use on your computer. Includes all 8.8 million physicians, clinics, nurses, dentists – all HIPAA-covered U.S. healthcare providers. Order a full download that you can use immediately in Microsoft Office Access software, or upload to your own FileMaker Pro or other database software.
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