Get National Provider Identifier (npi) Application/update Form 2020-2025

Completing the National Provider Identifier (NPI) Application/update Form online can be a straightforward process if you have the right guidance. This form is critical for health care providers seeking to obtain or update their unique identification number, ensuring proper recognition by insurers and regulatory bodies.

Follow the steps to accurately complete the online NPI Application/update Form.

1. Click ‘Get Form’ button to access the NPI Application/update Form online. Ensure you can view and interact with the document in the editor.
2. Begin by filling out Section 1, 'Basic Information.' Select the appropriate reason for submitting the form, whether it is an initial application, a change of information, deactivation, or reactivation. Be sure to provide your current NPI where required.
3. In Section 1B, identify your entity type by checking the appropriate box. Choose between 'individual who renders health care' or 'organization that renders health care.' Complete the necessary sections based on your selection.
4. Move to Section 2, 'Identifying Information.' Fill out your full legal name and any additional names you may have used. Be sure to provide details such as date of birth, state of birth, and Social Security Number (if applicable).
5. Continue to Section 3, 'Addresses and Other Information.' Populate your mailing address and practice location information, ensuring accuracy as this may affect how you are contacted regarding your application.
6. If applicable, complete the section on other provider identification numbers in Section 3C. This includes filling out any previous Medicare, Medicaid, or other identification numbers that relate to your practice.
7. In Section 4, 'Certification Statement,' read and certify that all provided information is true and complete. Sign and date the form. This step is essential for the integrity and processing of your application.
8. Lastly, complete Section 5, which requires contact information for a person who can address questions regarding your application. This information can be crucial in ensuring communication throughout the processing period.
9. Once you have filled out all applicable sections, save your changes in the online document, then download or print it for your records. If needed, share the completed form as per your requirements.

Start the online process now to submit your NPI Application/update Form!