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Viewpoint
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Viewpoint Archive
A Learner-Centered Infrastructure: The Next Generation Learning Management System—Ted Hanss, University of Michigan Medical School; Jill Jemison, University of Vermont College of Medicine; Susan Albright, Tufts University (Nov. 2008)
ePortfolios and Assessing Competence: The Western Reserve2 Curriculum—Terry Wolpaw, M.D., MHPE
Associate Dean for Curricular Affairs, Case Western Reserve University School of Medicine (Aug. 2008)
Web 2.0 and Medical Education: It's Here. Are You Ready?—James B. McGee, M.D., Associate Professor of Medicine, Assistant Dean for Medical Education Technology, Director, Laboratory for Educational Technology, University of Pittsburgh School of Medicine (May 2008)
More >>
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Do Medical Students, Interns, and Residents Need National Provider
Identifiers?
By Morgan Passiment
Director of Information Resources Outreach and Liaison, AAMC
The National Provider Identifier (NPI) is a Health Insurance Portability
and Accountability Act (HIPAA) Administrative Simplification Standard.
The NPI is a unique identification number for covered health care
providers.
All health care providers are eligible for NPIs and may apply
for them. Because medical students, interns, residents and fellow
are health care providers, they are eligible for NPIs. 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" health care providers under HIPAA and are
not required by the NPI Final Rule to obtain NPIs. If they do, however,
they would be covered health care providers and they must get NPIs.
If interns or residents prescribe medications for patients whose
prescriptions are filled by pharmacies, refer patients to other
health care providers, or order test for patients from other health
care providers, those pharmacies and other health care 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.
A Healthcare Provider Taxonomy Code for classifying medical students,
and interns and residents who are not yet licensed (based on state
licensing requirements), is available for use: Student Health Care
(390200000X). The code is defined as follows: An individual who
is enrolled in an organized health care education/training program
leading to a degree, certification, registration, and/or licensure
to provide health care. Medical students, interns, and residents
who are not licensed should select the Student, Health Care code
when applying for NPIs. Once licensed as a physician, the physician
should update his/her data in the National Plan and Provider Enumeration
System (NPPES) by submitting a change in the Healthcare Provider
Taxonomy Code to reflect the change in status from medical student
to physician.
Centers for Medicare & Medicaid Services NPI Resources
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