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Service Provider NPI Number

PRVDR_SRVC_PRVDR_NPI_NUM

A NUMBER IDENTIFYING THE NATIONAL PROVIDER IDENTIFIER (NPI) OF A SERVICE 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.contained.where(
  id = %root.provider.reference.substring(1)
).identifier.where(
  system = 'http://hl7.org/fhir/sid/us-npi'
).value
Coverage / Claim Type
  • Pharmacy
Source View
V2_MDCR_CLM
Source Column
PRVDR_SRVC_PRVDR_NPI_NUM
Sources
  • DDPS
Profiles
  • Basis
  • Regular
  • CMS

Notes

CCLF7.CLM_SRVC_PRVDR_GNRC_ID_NUM can provide NCPDP numbers in .008% of instances (among other rare ID types). These are surfaced as generic ID numbers, and may require a different FHIRPath expression (using system = "http://bluebutton.cms.gov/fhir/identifiers/GenericIdNum").

Mappings

CCW
  • SRVC_PRVDR_ID

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