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Update and Certify Provider Data in the Centers for Medicare & Medicaid Services’ National Plan & Provider Enumeration System

We are reaching out to you, our contracted health care provider, to remind you to review your National Provider Identifier (NPI) data in National Plan & Provider Enumeration System (NPPES) as soon as possible to ensure that accurate provider data is displayed.  As you may know, providers are legally required to keep their NPPES data current. Centers for Medicare & Medicaid Services (CMS) is also encouraging Medicare Advantage Organizations to use NPPES as a resource for our online provider directories.  By using NPPES, we can decrease the frequency by which we contact you for updated directory information and provide more reliable information to Medicare beneficiaries. 

If the NPPES database is kept up to date by providers, our organization can rely on it as a primary data resource for our provider directories, instead of calling your office for this information. With updated information, we can download the NPPES database and compare the provider data to the information in our existing provider directory to verify its accuracy.

When reviewing your provider data in NPPES, please update any inaccurate information in modifiable fields including provider name, mailing address, telephone and fax numbers, and specialty, to name a few.  You should also make sure to include all addresses where you practice and actively see patients and where a patient can call and make an appointment.  Do not include addresses where you could see a patient, but do not actively practice.  Please remove any practice locations that are no longer in use. Once you update your information, you will need to confirm it is accurate by certifying it in NPPES. Remember, NPPES has no bearing on billing Medicare Fee-For-Service. 

If you have any questions pertaining to NPPES, you may reference NPPES help. Please direct any general questions about this notice to your provider relations representative.

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Y0020_WCM_87476E Last Updated On: 11/17/2022