HIPAA

# Can you Apply for NPI Number without a License?

- November 11, 2024
- Posted by Brian Bertrand

29 Aug

Healthcare regulations ensure that only well-educated and skilled healthcare providers should render medical services to the provider. The National Provider Identifier (NPI) number is assigned to the providers to comply with all medical regulations and protocols.

NPI number is essential for those providers who wish to bill Medicare and Medicaid for patient care. However, there are some queries about the purpose of NPI numbers and requirements for obtaining NPI numbers, and these questions will be answered in this article.

Can you apply for an NPI number without a license online? This article will also discuss the online application process and the implications of doing so.

## Understanding NPI number

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 introduced NPI numbers to track healthcare providers for making transactions like billing and processing. It is a 10-digit code unique for each healthcare provider. In order to receive reimbursements for medical services from Medicare and Medicaid, healthcare providers should have an NPI number. Each healthcare provider is known by his NPI number and appears unique in the health records.

The most beneficial outcomes of assigning NPI numbers are standardizing healthcare provider identification and easy tracking and claiming.

## Can you Apply for NPI Number without a License?

Nearly all healthcare providers need a state license to apply for an NPI number, and they can’t proceed without a license. You can sometimes apply for an NPI number without a state license, but it has its own implications. Below are some cases in which a state license is not a mandatory thing in the application process:

### 1. Non-Licensed Healthcare Provider

Some of healthcare providers, including medical billing professionals and IT experts, do not require a license to get an NPI number. They work in the healthcare department and need an NPI number to process and maintain their transactions and records.

### 2. Student and Resident Healthcare Providers

Many students and resident practitioners work on their clinical rotations or academic activities; they need to get an NPI number to participate in medical projects or bill for services under supervision. This is also the case where a license is not required.

### 3. Alternative Medical Practitioners

Some healthcare workers, like naturopaths and holistic health coaches, don’t require any state license because of the nature of their services. They also need an NPI number to bill Medicare and Medicaid for their services. This is also the exception where it is again possible to apply for an NPI number without a license.

### 4. Volunteer Healthcare Providers

There is also a scenario where volunteer healthcare providers can render medical services in non-profit or community settings. They participate in various healthcare programs and need provider identification. Not for reimbursement but for identification in health records, they need an NPI number without having a license.

## Application Process for an NPI Number

Applying for an NPI number is simple and can be done using different methods. You can choose an online or physical application method. The online method is safe and reliable. You can have your NPI number as soon as possible online. There are steps how to apply online:

- Create a user account by putting your correct signup credential on the National Plan and Provider Enumeration System (NPPES) website. It requires your name, contact details, date of birth and email address for verification.
- Now, you need to choose the type of provider from the list available on the website. Can you apply for NPI number without a license online? Yes, in this step, choose a healthcare provider without a license.
- Now, it is time to fill out the application form carefully. Put information like name, address, working experience, Social Security Number (SSN), and Employer Identification Number (EIN) correctly. If you don’t possess a license then, you may have to add extra information like educational background, training certifications and working experience.
- Review all information and submit it online. You will get a confirmation email from the website about the status of your application. You can also track the application status from the website. Once the verification process and other protocols are done, you will receive your NPI number through your email. You are free to bill Medicare and Medicaid for the medical services.

## Conclusion

Obtaining an NPI number without a license is a crucial process, and research is needed to determine whether it is possible or not. NPI number makes the providers identified in the health records to avoid any confusion while tracking them. Medicare and Medicaid reimbursement cycle operates on the basis of NPI number. Can you apply for NPI number without a license? Yes, you can, but this is only applicable to some scenarios.

These scenarios include non-licensed healthcare providers, students and residents, alternative medicine practitioners, and volunteer healthcare workers. The application process is very simple and takes a few minutes. You need to go to the NPPES website, fill out the application form, and submit it. There are some legal, ethical, and recognition implications in getting an NPI number without a license. Always research and get expert advice before starting such processes. And we have also covered some relevant blogs to NPI Numbers Timelines, How to Find and what an NPI number actually is.

## FAQs

### 1. What is the actual diff b/w an NPI and license number?

NPI number is a 10-digit code for billing and administrative purposes assigned by the Medicare and Medicaid programs. While a license is the authorization to practice medicine in a certain area. It is issued by regulatory bodies after complete evaluation of educational, skill, training and certifications credentials. Please read this blog to know the diff between NPI & License Numbers in detail.

### 2. Can I start residency without an NPI number?

Yes, you can start residency without an NPI number but residents may need an NPI number during clinical rotations, administrative tasks and for billing under supervision.

### 3. Can you get an NPI as a medical student?

Yes, it is possible to get an NPI number as a medical student on the basis of participation in research and academic tasks. NPI number is also required for clinical rotations.

### 4. How is an NPI number generated?

NPI number can be generated by submitting an application on the National Plan and Provider Enumeration System (NPPES) website. It is cost free and easy to use. You just need to submit your personal and professional information accurately.

### 5. Is NPI the same as Tax ID?

No, NPI and tax ID are totally different. NPI number is code which is assigned to providers for billing purposes. It is used to get reimbursement from Medicare and Medicaid. Tax ID is a number assigned to businesses and organizations. It is assigned by the IRS to do tax reporting like filing taxes and paying employees.

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