Claim Operating Physician NPI Number (FFS)

This variable is contained in the following files:

Home Health Agency (Fee-for-Service) Hospice (Fee-for-Service) Inpatient (Fee-for-Service) Outpatient (Fee-for-Service) Skilled Nursing Facility (Fee-for-Service)

SAS Name

OP_PHYSN_NPI

On an institutional claim, the National Provider Identifier (NPI) number assigned to uniquely identify the physician with the primary responsibility for performing the surgical procedure(s).

NPIs replaced UPINs as the standard provider identifiers beginning in 2007. The UPIN is almost never populated after 2009.

Comments

CMS has determined that dual provider identifiers (old legacy numbers and new NPI) must be available in the NCH. After the 5/07 NPI implementation, the standard system maintainers will add the legacy number to the claim when it is adjudicated. We will continue to receive the OSCAR provider number and any currently issued UPINs. Effective May 2007, no new UPINs (legacy numbers) will be generated for new physicians (Part B and outpatient claims), so there will only be NPIs sent in to the NCH for those physicians.

Source: NCH