NPI Numbers > NPI Numbers
Group or Individual NPI
Michele:
You want to put the NPI of the provider performing the service in box 24J (the physical therapist) and the NPI of the where the reimbursement goes in box 33a. So if the PT is a solo provider billing under his own name (not a group name and tax ID) then you would put his individual NPI in 33a. Now, box 32a is suppose to be the corresponding NPI for the facility name in box 32 so if the physical therapist is billing under his own name and only has an individual NPI, and has multiple locations in his name, it would be his individual NPI.
I hope that is helpful and not more confusing! :-\
Michele
LW5689:
Michele, I think I am getting it. But what if the therapist is in addition to his own facility renting space from other proviers would I still put down the treating facility location but with his individual NPI #? in 32a I thought that the individual NIP # goes anywhere the provider would go? Forgive my ignorance.
Michele:
It's not ignorance, that is a good question. If the PT is credentialed to practice at these different locations/facilities, then even though the facility is not owned by the PT, he technically has a location at that facility. So you would enter his name, the facility address, and his NPI in box 32.
It's like he subrents space at the facility that he has his own little private practice at (even though it is not 'his' space and he is using their equipment. I'm just trying to show you what I'm saying.).
Hope that helps.
Michele
jcbilling:
I have a follow-up question about NPI's!
If all the dr's NPIs are linked to the group, does it matter what address is on their individual NPI's? or do they need to update their individual NPI's to reflect their practice address? How do you link the dr's to the group NPI - two of them are currently not linked.
Thanks so much!
- Charity
LW5689:
Can a provider who has an individual NPI # also be part of a group and have a group NPI #? Or is it one or the other? Can a provider bill individually if he provides services separately from the group at times?
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