Provider billing NPI number

PRVDR_BLG_PRVDR_NPI_NUM

A NUMBER IDENTIFYING THE NATIONAL PROVIDER IDENTIFIER (NPI) OF THE BILLING PROVIDER ASSOCIATED WITH THE CLAIM, AS SOURCED FROM THE NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM (NPPES). NOTE: THIS COLUMN IS POPULATED IF THE BILLING PROVIDER NPI ON THE CLAIM, AS PROVIDED BY THE SOURCE SYSTEM, CAN BE FOUND IN THE INTEGRATED DEPOSIT REPOSITORY (IDR) PROVIDER DATA AS SOURCED FROM NPPES.

Field Metadata

FHIR Resource: ExplanationOfBenefit
FHIRPath: ExplanationOfBenefit.contained.where( id = %root.provider.reference.substring(1) ).identifier.where( system = 'http://hl7.org/fhir/sid/us-npi' ).value
Coverage / Claim Type: Carrier
DME
HHA
Hospice
Inpatient
Outpatient
SNF
Source View: V2_MDCR_CLM
Source Column: PRVDR_BLG_PRVDR_NPI_NUM
Sources: FISS
MCS
NCH
VMS
Profiles: Basis
Regular
CMS

Example

1942945159

Notes

CLM_BLG_PRVDR_NPI_NUM is in CCLF, but not always present. PRVDR_BLG_PRVDR_NPI_NUM is always present on institutional claims.

Mappings

CCLF

CCLF1.FAC_PRVDR_NPI_NUM
CCLF1.CLM_BLG_PRVDR_NPI_NUM
CCLF6.CLM_BLG_PRVDR_NPI_NUM
CCLF6.PAYTO_PRVDR_NPI_NUM

CCW

ORG_NPI_NUM
PRVDR_NPI
CARR_CLM_BLG_NPI_NUM