"Suris-Fernandez, Rosali C. (CMS/OESS)" <rosali.surisfernandez@...> wrote:

Attention

medicare durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) suppliers

The Centers for Medicare and Medicaid Services (CMS) will be linking Medicare provider numbers with NPIs. 

As mentioned in the paper entitled, “Medicare Expectations on Determination of Subparts by Medicare Organization Health Care Providers Who Are Covered Entities Under HIPAA,” Medicare DME suppliers are required to obtain an NPI for every location.  The only exception to this requirement is the situation in which a Medicare DME supplier is a sole proprietor.  A sole proprietor is eligible for only one NPI (the individual’s NPI) regardless of the number of locations the supplier may have.

The requirement for Medicare DME suppliers to obtain NPIs for every practice location applies also to those Medicare DME suppliers who do not send electronic claims to Medicare.  Federal regulations require the unique enumeration of every location of a Medicare DME supplier regardless of how claims are submitted.  (Again, sole proprietors are eligible for only one NPI.)  

Failure to comply with this requirement may result in delayed processing or the rejection of Medicare claims.

For more information on Medicare Subpart Expectations, please visit the Medicare Subpart Guidance Paper at  http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/Medsubparts01252006.pdf

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