National Provider Identifier (NPI) Information

Page last updated on: 4/22/2008

All providers:

Applying for a NPI

If you have not requested your NPI(s) from the National Plan and Provider Enumeration System (NPPES) you must complete that process first then return to the Louisiana Medicaid NPI Registration application to register your NPI(s) after you have received it.

If you plan to enumerate with the NPPES in any other way than a one-to-one or if you have any other questions regarding the NPI please contact the Louisiana NPI Assistance Line at LAMedicaidNPI@Unisys.com or (225) 216-6400 so that we can discuss your NPI enumeration situation and determine the best method for accommodating your circumstance.

A new web based application has been developed for Louisiana Medicaid providers to register their NPI(s) with Louisiana Medicaid. The application is accessible from the secured provider area of this web site. You can enter this location of the web site by clicking the Provider Login button on the upper left side of this page. If you have not used this area of the web site before, you will be prompted to go through a short online registration process. Once signed in to the secured area providers will see a new application link called NPI.

Alternatively, providers may choose to register their NPI using the NPI paper registration form NPI paper registration form instead of the secured web application. The hard copy registration form is available for download from the list of helpful web links below. The paper form can be faxed or mailed back to Unisys.

Unisys will contact the registrant using the information provided on the registration form if there is any problem during registration.

Recommendations for Enumeration

Louisiana Medicaid will follow Medicare's enumeration recommendation which says that a provider should request a NPI for each of their legacy Medicaid ID numbers wherever possible. The primary reason for this recommendation is that it will assist Louisiana Medicaid in building the best possible cross-walk file from the NPI to the current Medicaid ID number which will continue to be used for internal processing.

When to Contact the NPI Enumerator for Assistance.

The topics with which the NPI Enumerator can assist providers are listed below:

Status of an NPI application, update, or deactivation
How to apply, update, or deactivate
Forgotten/lost NPI
Lost NPI notification
Trouble accessing NPPES
Forgotten password/User ID
Need to request a paper application

Health care providers needing assistance on any of the above topics may contact the NPI Enumerator at 1-800-465-3203, TTY 1-800-692-2326, or email the request to the NPI Enumerator at CustomerService@NPIenumerator.com.

The NPI application form, itself, is also a good source of information. Please refer to the NPI application instructions for clarification on information to be submitted in order to obtain an NPI or update an NPPES record. Refer to the 'Application Help' tab located on the NPPES website for additional assistance while online.

Louisiana Medicaid NPI Registration Application

Note: The Louisiana Medicaid Registration application is currently only accepting NPI information from providers that have requested and received an NPI for each Louisiana Medicaid ID (One NPI to One Louisiana Medicaid provider number relationship).

If you are choosing 1 NPI to multiple Medicaid provider numbers, or if you are a waiver provider, click here for more information.

Attention Group Practices: Group practices will need to register the NPI associated with the group Medicaid ID number as well as the NPIs assigned to the individual practitioners within the group. This is because LA Medicaid must be able to properly identify both the billing and servicing provider on claims. This means that both groups and individuals must be users of the secured area of the provider website to register their NPIs. If you are not a current user, you will need to complete a short signup process after you select the provider login button, and then you will have access. As an alternative to registering via the secured web application, group providers may contact the Louisiana NPI Assistance Line for details on how to register the group and their individuals using a bulk registration process.

Pharmacy providers:

Applying for an NPI

As well as the NPI enumeration methods listed above, pharmacy providers have an additional avenue for requesting a NPI through the NCPDP Bulk Enumeration process. NCPDP (the National Council on Prescription Drug Programs) has volunteered to assemble the NPI requests for their members into a bulk enumeration file that will be sent to the NPPES so that the applications can be processed together and disseminated back to the providers through a single channel. There is a link to the NCPDP web site below.

Louisiana Medicaid NPI Registration Application

Louisiana Pharmacy providers will have the ability to register their NPI with Louisiana Medicaid using the same NPI Registration application that all other provider types will use as described above. In addition, Louisiana Medicaid will be coordinating with the various pharmacy chain offices to register pharmacy NPIs in a group or bulk fashion where it is feasible. Chain offices that are going to bulk enumerate their pharmacies through the NPPES should contact the Louisiana Medicaid NPI Assistance group at LAMedicaidNPI@Unisys.com or call (225) 216-6400 to coordinate.

Transitioning to the NPI

The transition plan for Pharmacy providers will be slightly different than for other providers. The NCPDP 5.1 electronic claim format can accommodate either a Medicaid number or a NPI, but not both at the same time. Louisiana Medicaid currently allows billing Point of Sale pharmacy claims to Louisiana Medicaid with either the provider's Medicaid number or the provider’s NPI.

Since, the NCPDP 5.1 format permits only a single billing pharmacy identifier, qualifiers are very important data elements for determining the type of identifier submitted during the transition period. Therefore, DHH requires the provider to submit both the Service Provider ID Qualifier (NCPDP Field 202-B2), and the Prescriber ID Qualifier (NCPDP Field 466-EZ). A value of 01 = NPI or a value of 05 = Medicaid ID must be submitted in each of the qualifier fields.

Effective May 23, 2008, pharmacies must bill using their NPI in NCPDP field Service Provider Identifier (201-B1) as well as the prescribing provider’s NPI in NCPDP field Prescriber Identifier (411-DB).

Prescribing Providers NPI Cross Reference File - This link will take you to a downloadable text file that is delimited by “;”, containing the provider NPI cross reference to a Medicaid ID.