CMS National Plan and Provider Enumeration System (NPPES)
Investment ID: 009-000406261
Overview
Program Title
CMS National Plan and Provider Enumeration System (NPPES)
Description
NPPES was established by HHS regulations and CMS was delegated the authority to develop and maintain NPPES on behalf of HHS. NPPES assigns NPIs to eligible providers nationwide, and is not limited to those who enroll in Medicare or Medicaid.
Type of Program
Major IT Investments
Multi-Agency Category
Not Applicable
Investment Detail
The National Plan and Provider Enumeration System (NPPES) is a centralized, web-based system developed by CMS to create and maintain to assign standard unique identifiers for healthcare providers and health plans so that electronic transmission of health information can be accomplished more effectively, efficiently, and securely. The system was developed in response to implementation of the federal regulation 45 CFR Part 162 (NPI Final Rule). In addition, the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers for health care providers and health plans.
The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information as well as improve user verification and enhance waste, fraud, and abuse identification initiatives. In addition, NPPES makes Freedom of Information Act (FOIA) disclosable health care provider data available to the public as well and populates the data available to the public in the NPI Registry.
The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information as well as improve user verification and enhance waste, fraud, and abuse identification initiatives. In addition, NPPES makes Freedom of Information Act (FOIA) disclosable health care provider data available to the public as well and populates the data available to the public in the NPI Registry.