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News of the Day ... In Perspective


Time running out to delete DEA number from publicly available NPI data

If you have obtained an NPI, be aware that you have only until the end of June to delete “optional” elements supplied on your application from the publicly available NPI database.

The long-anticipated National Provider Identifier (NPI) Data Dissemination Notice was published in the Federal Register May 30, 2007. Despite concerns about identity theft and sale of NPI numbers, CMS apparently placed more weight on the insurance industry’s demand for an easily accessible look-up function to expedite claims processing and cash flow.

CMS states that the Freedom of Information Act (FOIA) requires very broad availability of data and that the Privacy Act only precludes release of Social Security Numbers, IRS Individual Taxpayer Identification Numbers, and date of birth.

Physicians who wish to delete “optional” data items including their DEA number can do so only until the online and downloadable data base is made available on June 30 or July 1. The files will be located at www.cms.hhs.gov/NationalProvIdentStand/.

Physicians should check their data in the National Plan and Provider Enumeration System (NPPES). The website is https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart. You must either use your already established UserIDs and password, or obtain a UserID and password to submit an update via the web. Or submit an update on paper by calling the NPI Enumerator and requesting a paper NPI Application/Update Form. The Enumerator can be reached at (800) 465-3203.

As AAPS has pointed out, and CMS has repeatedly acknowledged, HIPAA noncovered entities are not required by law to obtain an NPI. A number of private entities are asking for the NPI, however, and the pressure from private entities may prove difficult or impossible to resist. A number of physicians are delaying their application as long as possible. The one-year extension in implementation may be of some help, although the contingency plan requires covered entities to document that they exercised reasonable and diligent efforts to become compliant by the May 23, 2007 deadline date.

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