NRPM: Standard Health Care Provider Identifier. A. National Provider Identifier Initiative

05/07/1998

In July 1993, the Health Care Financing Administration (HCFA) undertook a project to develop a provider identification system to meet Medicare and Medicaid needs and ultimately a national identification system for all health care providers to meet the needs of other users and programs. Representatives from the private sector and Federal and State agencies were invited to participate. Active participants included:

  • Department of Defense, Office of Civilian Health and Medical Program of the Uniformed Services
  • Assistant Secretary for Planning and Evaluation, HHS
  • Department of Labor
  • Department of Veterans Affairs
  • Office of Personnel Management
  • Public Health Service, HHS
  • Drug Enforcement Administration
  • State Medicaid agencies and health departments including those of Alabama, California, Maryland, Minnesota and Virginia
  • Medicare carriers and fiscal intermediaries
  • Professional and medical associations, including the National Council for Prescription Drug Programs.

One of the group’s first tasks was to decide whether to use an existing identifier or to develop a new one. They began by adopting criteria recommended for a unique provider identifier by the Workgroup for Electronic Data Interchange (WEDI), Technical Advisory Group in October 1993, and recommended by the American National Standards Institute (ANSI), Healthcare Informatics Standards Planning Panel, Task Group on Provider Identifiers in February 1994. The workgroup then examined existing identifiers and concluded that no existing identifier met all the criteria that had been recommended by the WEDI and ANSI workgroups.

Because of the limitations of existing identifiers, the workgroup designed a new identifier that would be in the public domain and that would incorporate the recommendations of the WEDI and ANSI workgroups. This identifier, which we call the national provider identifier, or NPI, is an 8-position alphanumeric identifier.