Is our personal provider NPI adequate if we’re not billing Medicare (or other insurance)? I quickly ran it by Phil Eskew and he indicated that the provider NPI should typically suffice.
We have operating only under the provider NPI for ~4 years. Hasn’t been a problem so far!
Yes, the practice NPI is really only necessary when dealing with insurance. I have it for billing Medicaid (I have a hybrid safety net DPC) but otherwise have always used my own NPI for things.
Thank you! This is helpful. I thought that was the case, then a doc (who was insurance based his whole life until last 4-5 years prior to retirement turned DPC) told me I needed one and I was surprised. But then on more digging realized he had it prior to DPC.
Interestingly, I was just online at CMS yesterday checking this. I have a personal NPI, a pending one for the DPC practice (pending for two + years), and an old one from my insurance practice. The personal NPI shows me in PECOS and is the one I give out.
The lab we use says CMS told them my NPI is inactive as of 3/2016 (I opted out 4/1/2016) despite the CMS website showing my personal NPI as active.
I think CMS or their administrative company screw up periodically. We got the same call about six months ago and it went away without any action on our part.
Without a doubt!
Practice NPI is free to get. I was asked for it when applying for a few things - May have been able to get away with putting in personal NPI but wasn’t a big deal to get it. Think one was an application to do physicals for VES and the other was something medical that I wanted to buy.