NPI Number FAQ

An NPI (National Provider Identifier) is a unique 10-digit identification number issued by CMS (Centers for Medicare & Medicaid Services) to every healthcare provider in the United States. It is required on all standard electronic and paper healthcare transactions — including claims, eligibility checks, referrals, and prior authorizations.

The NPI is assigned permanently to the individual or organization and does not change even if the provider moves, changes specialties, or changes health plans.

There are two types of NPIs:

• Type 1 (Individual): Assigned to individual healthcare providers — physicians, dentists, nurses, therapists, pharmacists, and any other person who provides healthcare services. Each individual provider has exactly one NPI.
• Type 2 (Organizational): Assigned to healthcare organizations — group practices, hospitals, outpatient clinics, laboratories, pharmacies, home health agencies, and other entities that furnish healthcare services. An organization may have multiple Type 2 NPIs for different locations or departments.

You can browse individual providers or browse organizations from our directory.

Yes. An NPI can be deactivated by CMS (e.g., upon the provider's death or dissolution of an organization) or by the provider themselves. A deactivated NPI cannot be used for billing. In rare cases, an NPI may be replaced by a new NPI, and the old one will show a replacement NPI on the record.

NPI Lookup shows deactivation status on each provider record. Active providers are marked with an "Active NPI" badge.

A sole proprietor is an individual healthcare provider who operates as a self-employed business without a separate legal entity. Sole proprietors use their individual (Type 1) NPI for all Medicare transactions. NPPES records include a sole proprietor indicator on individual provider records.

Yes. Enter the 10-digit NPI number in the search box on the home page or the search page. NPI lookups return the full provider record instantly without requiring a location.

Go to the provider search and enter the provider's last name (for individuals) or organization name. You must also provide either a state and city, or a ZIP code. Searching by name alone without a location is not supported, as it would return too many results from across the country.

The search supports partial names — entering "Smith" will return all providers with "Smith" in their last name in the specified location.

Searching by a broad location like a state alone (without a city or ZIP code) combined with a taxonomy code returns too many results and typically causes the query to time out. The search requires a city or ZIP code when using specialty/taxonomy filters to ensure results are returned quickly and accurately.

Yes. When searching by provider name and location, you can filter to show only providers enrolled in Medicare (PECOS). This is useful for compliance checks when you need to verify that a referring or ordering provider is Medicare-enrolled.

If you are a healthcare provider, you can find your NPI by:

• Searching the NPI Lookup search by your name and state.
• Logging into the NPPES (National Plan and Provider Enumeration System) portal at nppes.cms.hhs.gov.
• Checking your CMS approval letter or your health plan credentialing correspondence, which should include your NPI.

PECOS (Provider Enrollment, Chain and Ownership System) is CMS's centralized database of all providers and suppliers enrolled in the Medicare program. Before a provider can bill Medicare, they must be enrolled in PECOS and receive approval.

You can verify PECOS enrollment using a provider's PAC ID or Enrollment ID, or check a provider's PECOS status from any NPI lookup result.

A PAC ID (Provider Associate Level Variable) is a 10-digit identifier assigned by CMS to each enrolled Medicare provider. It is unique to the individual or organization and links all of their Medicare enrollment records across different states and programs.

PAC IDs appear in CMS's Physician Compare dataset and on provider NPI records when the provider is enrolled in Medicare.

An Enrollment ID is a 15-character identifier (starting with I for individuals or O for organizations, followed by 14 digits) that uniquely identifies a single Medicare enrollment record. A provider may have multiple Enrollment IDs if they are enrolled under different Medicare programs or in different states.

Example: I20220224002430

CMS requires ordering and referring physicians to be enrolled in Medicare (either as a participating or non-participating provider) for Medicare to cover certain services — including home health, DME (durable medical equipment), clinical laboratory services, and imaging. If the ordering/referring provider is not in PECOS, Medicare will deny the claim.

This requirement was strengthened under the Affordable Care Act to reduce fraud and ensure providers are properly vetted before ordering Medicare-covered services.

A provider who is not in PECOS has not completed Medicare enrollment with CMS. This does not necessarily mean they cannot see Medicare patients — a provider may see Medicare patients but not directly bill Medicare (e.g., they could work under a group practice that is enrolled). However, they cannot independently submit Medicare claims or serve as the ordering/referring provider on Medicare claims.

The OIG LEIE (List of Excluded Individuals and Entities) is a database maintained by the HHS Office of Inspector General. It lists healthcare providers who have been excluded from participating in federally funded healthcare programs — including Medicare, Medicaid, CHIP, and other federal programs — due to fraud, patient abuse, felony convictions, or other violations.

Need automated LEIE screening for your roster? Provider Signals Risk monitors up to 25 providers free →

Submitting a claim to Medicare, Medicaid, or any other federal healthcare program for services performed by or at the direction of an excluded provider is a federal violation. Penalties include:

• Civil monetary penalties of up to $20,000 per claim
• Exclusion of the billing entity itself from federal programs
• Repayment of all claims paid during the period the excluded provider was employed or contracted

Employers and contractors are responsible for screening all providers they employ or contract with against the LEIE — including physicians, nurses, technicians, and billing staff.

The OIG recommends screening all providers at hire and then monthly thereafter. This is because new exclusions are added to the LEIE every month. Many compliance programs and state Medicaid agencies require monthly screening as a condition of participation.

For automated monthly screening across your entire provider panel, see Provider Signals Risk by NPI Data Services.

Every provider detail page shows a LEIE status indicator. Providers confirmed on the OIG exclusion list are prominently flagged with a warning badge. Providers not on the exclusion list are shown with a "Not on OIG Exclusion List" confirmation. Data is sourced from the monthly LEIE update published by the OIG.

Note: LEIE status shown here is matched by NPI. Non-NPI exclusions (e.g. billing staff, entities without an NPI) are not included. For a full name-based exclusion search, use the free LEIE Lookup tool →

A billing NPI is the NPI submitted on insurance claims to identify who is billing for the service. Individual providers bill under their Type 1 (individual) NPI. Group practices and facilities bill under their Type 2 (organizational) NPI. When a provider renders services within a group, the group's NPI is the billing NPI and the individual's NPI appears as the rendering provider NPI on the claim.

Payers use the billing NPI to verify enrollment, determine contracted rates, and process reimbursement. Verifying that a billing NPI is active and enrolled in the relevant payer network is a standard step in revenue cycle management.

The NPI registry is managed by CMS through NPPES (National Plan and Provider Enumeration System). To contact the NPI Enumerator directly:

• Phone: 1-800-465-3203 (NPI Enumerator hotline, Mon–Fri 7:30 AM–6:30 PM CT)
• Email: customerservice@npienumerator.com
• Web: nppes.cms.hhs.gov

The NPI Enumerator handles new NPI applications, updates to existing records, and deactivation requests. NPI Lookup is not affiliated with CMS or NPPES — for changes to your NPI record, use the official NPPES portal or contact the Enumerator directly.

NPI numbers and DEA numbers are separate identifiers maintained by different federal agencies. The NPI is issued by CMS through NPPES. The DEA registration number is issued by the Drug Enforcement Administration to providers who are authorized to prescribe controlled substances.

This NPI Lookup does not include DEA registration data. To verify a DEA registration, use the DEA Diversion Control Division's online lookup at deadiversion.usdoj.gov. You can use a provider's NPI to identify them here, then cross-reference by name and state with the DEA's system.

No. A DEA registration is only required for providers who prescribe, dispense, or administer Schedule II–V controlled substances. Many healthcare providers — including those who exclusively prescribe non-controlled medications — do not have or need a DEA number. An active NPI does not imply DEA registration.

State Prescription Drug Monitoring Programs (PDMPs) typically use both the NPI and DEA number to identify prescribers. The NPI provides the standardized identifier for the provider in the NPPES registry, while the DEA number confirms controlled substance prescribing authority. Insurance claims use the NPI; DEA number verification is done separately through the DEA or state licensing boards.

NPPES (National Plan and Provider Enumeration System) is the CMS system that providers use to apply for, update, and manage their NPI numbers. It is the authoritative source — when a provider submits an application or change, NPPES processes and stores the record.

The NPI Registry is the public-facing searchable database of all assigned NPIs. In common usage the terms are interchangeable, but technically NPPES is the application and management system while the NPI Registry is the read-only public lookup interface. This site queries the NPI Registry data published monthly by CMS.

Log in to the NPPES portal at nppes.cms.hhs.gov with your NPPES account. You can update your practice address, taxonomy codes, contact information, and authorized official. Changes typically appear in the public NPI Registry within 30 days when CMS publishes the next monthly data update.

If you cannot access your NPPES account, contact the NPI Enumerator at 1-800-465-3203 or by email at customerservice@npienumerator.com.

Yes — "NPI Registry," "NPPES NPI Registry," and "NPI database" all refer to the same publicly available dataset of NPI records published by CMS. Third-party tools like this one consume the same underlying CMS data. The official CMS interface is at npiregistry.cms.hhs.gov; this tool provides a faster, more detailed search interface with PECOS and LEIE data integrated alongside NPI records.

A taxonomy code is a 10-character NUCC (National Uniform Claim Committee) code that classifies a healthcare provider's type, classification, and specialization. Taxonomy codes are used in NPI records, HIPAA transactions, and claims processing.

Examples:

• 207R00000X — Internal Medicine physician
• 363L00000X — Nurse Practitioner
• 282N00000X — General Acute Care Hospital

Browse the full taxonomy code reference on this site.

Yes. A provider may have up to 15 taxonomy codes on their NPI record. One code is designated as the primary taxonomy, which represents their main specialty or classification. Additional codes can represent other specialties or sub-specialties they practice. NPI Lookup displays all taxonomy codes on each provider record.

Use the provider search and enter the 10-digit taxonomy code (e.g., 207R00000X) along with a state and city. You can also browse by specialty from the Doctors or Organizations directories, which are organized by taxonomy group.

All provider data comes from official government sources:

• NPI records: NPPES (National Plan and Provider Enumeration System), published by CMS
• PECOS enrollment: CMS Provider Enrollment, Chain and Ownership System
• LEIE exclusions: OIG List of Excluded Individuals and Entities
• Taxonomy codes: NUCC (National Uniform Claim Committee) taxonomy code set

This tool is not affiliated with CMS or HHS. All data is sourced from publicly available government datasets.

Our database is refreshed on a monthly cycle, matching the CMS NPPES monthly update schedule. Provider records, addresses, taxonomy codes, PECOS enrollment status, and LEIE exclusion flags are all updated monthly.

The footer of each page shows the current data period. Individual records display the last-updated date from NPPES.

This tool provides access to publicly available government data and is intended for informational purposes. For credentialing, compliance, or billing decisions, always verify information against the official primary sources:

• NPPES NPI Registry — nppes.cms.hhs.gov
• PECOS — pecos.cms.hhs.gov
• OIG LEIE — exclusions.oig.hhs.gov

For automated compliance monitoring and programmatic access, see the NPI Registry API.

Yes. The NPI Lookup tool is free to use with no account or API key required. You can look up as many providers as you need.

If you need programmatic or bulk access to provider data, the NPI Registry API offers a free trial tier and paid plans for higher-volume use.

No. NPI Data Services and this NPI Lookup tool are not affiliated with, endorsed by, or operated by CMS, HHS, or any government agency. This is an independent service that provides convenient access to publicly available government data. All data is sourced from official CMS and OIG publications.