Health care providers who are covered entities under HIPAA are required by the National Provider Identifier (NPI) Final Rule to update their NPPES data. The Final Rule [at (162.410(a)(4)] states that covered healthcare providers must notify the NPPES of changes in their required NPPES data elements within 30 days of the changes. Failure to provide updated information may be considered an act of non-compliance with the NPI regulation, and a complaint may be filed against covered health care providers who do not comply with this provision or any other provisions of the rule.
Most updates and changes can be made by health care providers over the Web, using the User IDs and passwords they selected when they first applied for their NPIs. If they applied on paper, most health care providers can submit updates or changes over the Web and can select User IDs and passwords at the time of the update. Certain changes or updates, however, must be made on paper (form CMS-10114), as they require the original signature of the health care provider or for an organization health care provider the signature of the Authorized Official. Such changes include:
- Applications for NPIs, and all updates/changes, from individuals who do not have SSNs or who do not want to report their SSNs to NPPES
- All requests to deactivate NPIs
- All requests to reactivate NPIs
- All changes to incorrectly submitted SSNs
- All changes to incorrectly submitted dates of birth
- All changes to incorrectly submitted Employer Identifier Numbers (EINs)
- All changes of EINs
- Password resetting changes due to changes to the Contact Person or Authorized Official
When to Contact the NPI Enumerator for Assistance
Your health plans cannot assist you with NPI questions that should be directed to the NPI enumerator. However, the issues with which the NPI Enumerator can assist you are also limited to the following topics:
- Status of an NPI application, update or deactivation
- Forgotten/lost NPI
- Lost NPI notification
- Trouble accessing NPPES
- Forgotten password/User ID
- Need to request a paper application
Health care providers needing this type of assistance may contact the NPI Enumerator at (800) 465-3203, TTY (800) 692-2326 or e-mail the request to the NPI Enumerator at
CustomerService@NPIenumerator.com.
The NPI application is also a good source of information. Please refer to the NPI application instructions for clarification on information to be submitted in order to obtain an NPI or update your record. You can also refer to the 'Application Help' tab located on the NPPES Web site for additional assistance while you are online.
Resources for other kinds of questions can be found at the end of this document.
Note: The NPI Enumerator's operation is closed on federal holidays.