National Provider Identifier (NPI)

Applying for your National Providers Identifier

Effective October 1, 2009 , the taxonomy code was assigned to the role of the Doula and defined under the Nursing Service Related Providers Type. This code enables ICTC Certified Doulas to obtain an NPI (National Providers Identifier) Number to submit reimbursement claims to Medicaid and 3rd Party Insurance Companies.

What is an NPI?

The National Provider Identifier is a unique 10-digit numeric identifier used for administrative and financial transactions within the health care system under HIPPA Guidelines. Such transactions include claims and encounter information, claims status, coordination of benefits and premium payment, eligibility and enrollment, payment, referrals, and authorizations.

NPI was created to meet the needs of those enrolled in federal and private health programs in an effective and efficient manner. (https://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/NationalProvIdentStand/Downloads/NPIfinalrule.pdf).

Who Must Obtain an NPI?

All healthcare providers (physicians, suppliers, hospitals, and doulas) covered under HIPAA must obtain an NPI. There are two categories of healthcare providers: Category 1 is Individual Healthcare Providers, Sole Proprietors and Category 2 is Organization Healthcare Providers.

Taxonomy Code for Doulas:

Taxonomy codes are administrative codes set for identifying the practitioner type and area of specialization for health care practitioners, including doulas. When applying for an NPI, utilize taxonomy code 374J00000X. This code is listed under the heading of “Nursing Service Related Providers Type”.