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Depending on whether you qualify as an individual or small group practice, or are considered a large organization, your qualification will determine how you can update your NPI of record.A key to finding the correct physician is accurate information in that database.

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The national revalidation effort by the Centers for Medicare & Medicaid Services (CMS) is a big step in improving the accuracy of Medicare provider enrollment data.

This effort has helped bring awareness to physicians of the importance of updating their records in a timely manner when addresses, organizational structure, key contacts, phone numbers, etc. However, few physicians think to update their NPI record to ensure it stays as current as their enrollment.

The National Plan and Provider Enumeration System (NPPES), which houses National Provider Identifier (NPI) numbers, is not always consistent with information in the Provider Enrollment, Chain and Ownership System (PECOS).

Department of Health & Human Services Office of the Inspector General, 58 percent of the databases used to determine provider identities and help to prevent the occurrence of fraud are inaccurate or incomplete.

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Add the updating of NPPES to your list of items to check each time you make a change, or at least annually. Contact: CMA reimbursement help line, (888) 401-5911 or [email protected] you already have your national provider identifier (NPI), but have recently changed your office contact numbers, address or contact person, you will need to update your NPI as soon as possible.

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