Prerequisites
- Type 2: the PC formed, with its EIN and the CP 575 letter in hand
- Type 1: the clinician’s SSN, license, and credentials
- A CMS Identity & Access Management (I&A) account
Type 1, individual
Check whether the clinician already has one first. Type 1 NPIs follow the person for life, across every employer. A clinician who applies for a second creates a duplicate that causes claim rejections for years and is painful to deactivate. Search the NPI Registry by name before applying. Most clinicians obtained theirs in training. If they genuinely don’t have one:1
Create an I&A account
At nppes.cms.hhs.gov, which authenticates through CMS I&A.
2
Apply as an individual (Entity Type 1)
Legal name as it appears on the license, SSN, date of birth, license number and state, and practice location.
3
Select taxonomy
Their specialty. See below.
4
Submit and wait
Typically days to two weeks.
Type 2, organizational
1
Wait for the EIN
The application requires it. You cannot do this before formation completes.
2
Apply as an organization (Entity Type 2)
The exact legal name from the CP 575, EIN, practice location address, mailing address, and taxonomy.The legal name is not cosmetic. Payers match enrollment against IRS records. If the CP 575 says “PRIYA SHAH MD PC” and NPPES says “Meridian Dermatology,” you will spend months resolving mismatches across every payer. Use the IRS name in the legal name field and put the brand in “other name.”
3
Name the authorized official
A person with legal authority to bind the entity. Given officer licensure rules in many states, this is usually the clinician-owner. Their credentials are required for future changes, so record who it is.
4
Select group taxonomy
The practice’s specialty, or
193200000X (Multi-Specialty Group) where appropriate.5
Submit and wait
Typically a few days to two weeks.
Taxonomy selection
A taxonomy code is a 10-character code identifying provider type, classification, and specialization, from the code set maintained by the National Uniform Claim Committee.1 Two rules that prevent a great deal of pain:- The taxonomy on your claims must match the taxonomy you enrolled with. Mismatches produce denials that look mysterious because nothing clinical is wrong.
- Group and individual taxonomies are different. The Type 2 carries a group taxonomy; each Type 1 carries the clinician’s own.
Subparts
A Type 2 NPI can have subparts, additional organizational NPIs for distinct components with different locations or taxonomies. Most single-location practices do not need one. Consider them when a payer requires location-level identification, or when one legal entity operates genuinely distinct service lines with different taxonomies.Keeping NPPES current
NPPES data feeds payer directories and provider lookups. Stale data causes real problems — claims rejections, patients unable to find you, and payer directory accuracy findings. Update within 30 days of any change to:- Practice location or mailing address
- Phone or fax
- Authorized official
- Taxonomy
- Legal name (e.g., after an entity name change)
- License information
Verify it worked
- Clinician’s existing Type 1 confirmed via the NPI Registry — no duplicate created
- Type 2 issued to the PC
- NPPES legal name matches the CP 575 exactly
- Taxonomies selected for both, and recorded
- Authorized official recorded, with their I&A credentials retained by the organization
- Both NPIs verifiable in the public NPI Registry
- Annual NPPES review calendared
Common failure modes
Sources
- National Uniform Claim Committee, Health Care Provider Taxonomy. CMS, NPI Standard.