How to Obtain an NPI for Your Laboratory

Every medical laboratory that intends to bill insurance (Medicare, Medicaid, or commercial plans) must have a National Provider Identifier (NPI). Unlike a physician who carries their NPI with them wherever they work, a laboratory requires a distinct organizational NPI to operate as a business entity.

This guide will walk you through the process of applying for a Type 2 (Organization) NPI via the National Plan and Provider Enumeration System (NPPES).

Phase 1: The Critical Distinction (Type 1 vs. Type 2)

Before you begin, you must understand which NPI you are applying for.

• Type 1 (Individual): For human beings (Doctors, Nurses, Pharmacists). Do not apply for this for your lab.
• Type 2 (Organization): For business entities (Hospitals, Clinics, Laboratories).
• The Rule: If your lab has an Employer Identification Number (EIN) and you bill for services as a company, you need a Type 2 NPI.

Phase 2: Gather Your Data

The application has a time-out feature. To avoid losing progress, have the following information ready before you log in:

1. Legal Business Name: This must match exactly what is on your IRS CP-575 letter (the letter assigning your EIN).
2. Employer Identification Number (EIN): You cannot use a Social Security Number for a Type 2 NPI.
3. Mailing and Practice Addresses:
   • Practice Location: Must be a physical address (cannot be a PO Box).
   • Mailing Address: Can be a PO Box or billing office.
4. Taxonomy Code: This is the code that tells the government "We are a Lab."
   • The most common code for a general lab is: 291U00000X (Clinical Medical Laboratory).
5. Authorized Official Information: Name, SSN, and phone number of the person legally authorized to sign for the company (e.g., Owner, CEO, Administrator).

Phase 3: The Application Process

Step 1: Create an I&A Account

You cannot access the NPI system without a "passport" called the Identity & Access Management System (I&A) account.

1. Go to nppes.cms.hhs.gov.
2. If you (the individual user) do not have an I&A account, click "Create or Manage an Account."
3. Follow the steps to verify your personal identity. Note: You are creating this account as a human being who acts on behalf of the lab.

Step 2: Log in to NPPES

Once your I&A account is active:

1. Return to nppes.cms.hhs.gov.
2. Log in with your User ID and Password.
3. Click the button that says "Apply for an NPI for an Organization."

Step 3: Complete the Application

The system will guide you through several pages.

• Provider Profile: Select "Organization" (Type 2).
• Business Information: Enter the Legal Business Name and EIN.
  • Pro Tip: If your EIN is very new (less than 2 weeks old), the system might not recognize it yet. You may have to wait for the IRS database to sync with NPPES.
• Addresses: Enter the physical location of the lab. If you have a separate billing address, enter that in the "Mailing Address" section.
• Taxonomy:
  • Click "Add Taxonomy."
  • Filter by "Laboratories."
  • Select 291U00000X - Clinical Medical Laboratory.
  • Make this the "Primary" taxonomy.
  • Note: If you are a specific type of lab (e.g., Physiological Lab), search for that specific code, but "Clinical Medical Laboratory" covers most general diagnostic labs.
• Contact Person: Enter the details of the person who should be contacted if there are issues with the application.

Step 4: Certification and Submission

1. The Authorized Official must certify the application.
2. Read the terms, check the box, and click "Submit."

Phase 4: What Happens Next?

1. Processing Time

Online applications are incredibly fast. You will often receive your NPI via email within 1 to 24 hours. In rare cases where manual verification is needed, it may take up to 10 days.

2. The NPI Registry

Once issued, your NPI is public record. It will appear in the NPI Registry, allowing other providers to find you for referrals.

3. This is NOT Medicare Enrollment

Crucial Warning: Getting an NPI does not mean you are enrolled in Medicare. It simply gives you the ID number required to apply for Medicare.

• Next Step: Once you have your NPI, you will take that number and go to PECOS (as detailed in the previous guide) to formally enroll the lab as a Medicare supplier.