1. National HIPAA Audioconference: Analysis of the National Provider Identifier
Steven S. Lazarus, PhD, CPEHR, CPHIT, FHIMSS
President
Boundary Information Group
January 11, 2006

2. Strategic IT business process planning
ROI/benefits realization
Project management and oversight
Workflow redesign
Education and training
Vendor selection and enhanced use of vendor products
Facilitate collaborations among organizations to share/exchange health care information
Business process consultant focusing on electronic health records, and electronic transactions between organizations
Former positions with MGMA, University of Denver, Dartmouth College
Active leader in the Workgroup for Electronic Data Interchange (WEDI)
Speaker and author (two books on HIPAA Security and one on electronic health records)
Co-Founder of Health IT Certification
Steve Lazarus. Boundary Information Group Strategies for workflow, productivity, quality and patient satisfaction improvement through health care information

3. History of NPI 1993 WEDI Report recommended four Standard Identifiers
Patient
Provider
Payer
Employer
1996 HIPAA legislation includes these four identifiers
1998 National Provider Identifier NPRM
2004 National Provider Identifier Final Rule
May 2007 NPI use required by all CEs except small health plans (May 2008)

4. Simple NPI: The Vision
Most health care providers receive one unique number for life
No cost to apply for the number
All health plans must use the number and stop requiring proprietary numbers by May, 2007 (May, 2008 for small health plans)
NPIs are obtained from NPPES (NPPES.cms.hhs.gov/NPPES/WELCOME.do)
Provider NPI application process
NPI dissemination to health plans and others

5. Types of NPIs
Type 1 – Individual NPI: An individual health care provider may obtain a single NPI to identify the person for life
Type 2 – Organizational NPI is a provider that is not an individual. It is a legal entity such as government, corporation, partnership. It obtains one NPI for the whole, and it may obtain NPIs for its Subparts.

6. What are the Barriers? Obtaining the numbers Distributing the NPIs
Only a few hundred thousand numbers issued so far
Bulk enumeration not available yet
Distributing the NPIs
Health plans, hospitals and others need to access the new numbers
Information processing issues
Matching current provider/identifier to the NPI
Designing and implementing new data flows and uses without proprietary number
Determining subparts (for Medicare) and their Type 2 NPIs

7. NPIOI
WEDI established the National Provider Identifier Outreach Initiative in 2005
Established the WEDI National NPI Resource Center

8. Contact Information
Steven S. Lazarus, PhD, CPEHR, CPHIT, FHIMSS
President
Boundary Information Group
(303)