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Single-member LLC NPI type?

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katyus:
Hello-

I have a single member LLC. Is it true I need to register for both a type 1 and type 2 NPI number. If so, why? And if so, for the individual registration, so I select "no" when it asks if I am a sole proprietor? Because technically, I am not - I am technically a single member LLC.

Thanks in advance!

Michele:
Yes you need both a type 1 and a type 2 NPI.  You need the type 1 for yourself individually as a rendering provider.  You need the type 2 for your LLC.  Since you have an LLC with an EIN and a legal business name you need an type 2 NPI for the entity.  It seems confusing since you are just one provider but when you formed the LLC you 'created' a separate entity from yourself which needs it's own NPI.  I hope that helps!

RichardP:
An easy way to keep things straight in your head is to answer two questions:

1.  Who did the work?  (Needs a Type I NPI Number)
2.  Who gets paid?  (who is the billing entity)  (Needs a Type II NPI Number **)

Organizations are creations of the state, legal entities, but they can never do work.  Only a human can.  So Organizations can never have a Type I NPI Number (who did the work).

** With this exception:  the only way that the answer to both questions can be "me" is if you have applied for an NPI Number using your Social Security Number, and all payments for services rendered are made out to your personal, legal name.  If that is the truth in your case, then you only need a Type 1 NPI Number.  (NPI Number linked to your Social Security Number.)

If you bill using your LLC's legal name, and/or you receive payment made out to your LLC's legal name, then your LLC is the billing entity, the one who gets paid (Question 2 above) - and therefore needs it's own, Type II, NPI Number.  (NPI Number linked to your orgnization's EIN.)

The thing that trips people up is the distinction between sole proprietor (doing business in your own name, using your own SSN, having created no organization) and a sole practitioner or solo practitioner (having obtained an EIN, and doing business in the name of your organization).  See the top of Page 5 at this link: [edit: see also the bottom of Page 4]

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/NPIBooklet.pdf


dekenn:
Actually, you can be a sole proprietor with an EIN and a "doing business as" name and still have a Type 1 NPI. I believe the difference is that you are not incorporated (LLC, corporation, partnership, etc)  in any way. Even a sole proprietor needs an EIN in order to pay employees and submit payroll taxes for those employees and when you register for that, you can create a "doing business as" name without incorporating. It's just a business, not a corporation.
Maybe it depends on what state you're in, we are in NJ and that is how we are set up.

katyus:
Thanks everyone! I am in Connecticut - anyone know how it's set up here?

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