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Other Physician NPI

PRVDR_OTHR_PRVDR_NPI_NUM

A NUMBER IDENTIFYING THE NATIONAL PROVIDER IDENTIFIER (NPI) OF AN OTHER PROVIDER AS SOURCED FROM THE NPI CROSSWALK REFERENCE INFORMATION PROVIDED BY THE NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM (NPPES).

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath
ExplanationOfBenefit.careTeam.where(
role.coding.where(code = 'otheroperating').exists()
).provider.identifier.value or
ExplanationOfBenefit.careTeam.where(
role.coding.where(code = 'supervisor').exists()
).provider.identifier.value
Coverage / Claim Type
  • Carrier
  • HHA
  • Hospice
  • Inpatient
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM
Source Column
PRVDR_OTHR_PRVDR_NPI_NUM
Sources
  • FISS
  • MCS
  • NCH
Profiles
  • Basis
  • Regular
  • CMS

Notes

This element traditionally refers to institutional claims. However, processing professional claims also populate the "supervisor" value for professional claims with a supervision relationship (eg MD supervising NP).

Mappings

CCLF
  • CCLF1.OTHR_PRVDR_NPI_NUM
  • CCLF1.CLM_OTHR_PRVDR_NPI_NUM
CCW
  • OT_PHYSN_NPI
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