NRPM: Standard Health Care Provider Identifier. § 142.402 National provider identifier standard.


(a) The provider identifier standard that must be used under this subpart is the national provider identifier, which is supported by the Health Care Financing Administration. The national provider identifier is an 8-position alphanumeric identifier, which includes as the eighth position a check digit.

(b) The file containing identifying information for each health care provider for its national provider identifier includes the following information:

(1) The national provider identifier.

(2) Other identifiers, such as the social security number (optional), employer identification number for some provider types, and identifying numbers from other health programs, if applicable.

(3) Provider names.

(4) Addresses and associated practice location codes.

(5) Demographics (date of birth, State/country of birth, date of death if applicable, race (optional), sex).

(6) Provider type(s), classification(s), area(s) of specialization.

(7) Education for certain provider types, State licensure for certain provider types (optional), and board certification (optional for some classifications).