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Rendering Provider NPI Number - Line Level

PRVDR_RNDRNG_PRVDR_NPI_NUM

A NUMBER IDENTIFYING THE NATIONAL PROVIDER IDENTIFIER (NPI) OF THE PROVIDER WHO RENDERED THE SERVICE, AS SOURCED FROM THE NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM (NPPES). NOTE: THIS COLUMN IS POPULATED IF THE RENDERING 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.careTeam.where(
  role.coding.where(code = 'rendering').exists()
).provider.identifier.value
Coverage / Claim Type
  • Carrier
Source View
V2_MDCR_CLM_LINE
Source Column
PRVDR_RNDRNG_PRVDR_NPI_NUM
Sources
  • MCS
  • NCH
Profiles
  • Basis
  • Regular
  • CMS

Example 

1942945159

Notes

This can be either the same or different as the other rendering provider fields. An alternative way to connect the nodes is to refer to the relevant careTeam sequence and then get the Provider's NPI from there.

Mappings

CCLF
  • CCLF5.RNDRG_PRVDR_NPI_NUM
  • CCLF5.CLM_RNDRG_PRVDR_NPI_NUM
CCW
  • CARR_LINE_PRFRMG_NPI_NUM
  • RNDRNG_PHYSN_NPI
  • PRF_PHYSN_NPI

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