Only an NPI may be entered in any provider identifier fields on claims submitted on or after May 23, 2008. Claims will be rejected when submitted with a Medicare legacy number (PIN/PTAN) or a UPIN in any provider identifying field on or after May 23, 2008.
Type 1 is an individual NPI. Type 2 is an organizational NPI.
Incorporated Individual with individual legacy number and individual NPI:
24J – Enter nothing
33a – Enter type 1 Individual NPI
Incorporated Individual with individual legacy, group legacy, individual
NPI and group NPI:
24J – Enter type 1 Individual NPI
33a – Enter type 2 Corporation NPI
Sole Proprietor, not billing for an employee:
24J – Enter nothing
33a – Enter type 1 Individual NPI
Sole Proprietor, billing for an employee:
24J – Enter type 1 Employee individual NPI
33a – Enter type 1 Individual NPI in
Clinics and multiple group offices:
24J – Enter type 1 Individual NPI
33a – Enter type 2 Group NPI
Organizations/Facilities (e.g. ASC, Ambulance, IDTF, etc.):
24J – Enter nothing
33a – Enter type 2 Facility NPI
Provider set up as a group (individual and group legacy) and only one NPI:
Contact Provider Enrollment: (888) 608-8816 [Select Option 1]