CMS to deactivate NPIs where NPPES info conflicts with IRS data
The Centers for Medicare and Medicaid Services (CMS) is currently auditing organizational (Type 2) health care provider data submitted to the National Plan and Provider Enumeration System (NPPES). Specifically, a comparison of NPPES-IRS data is being conducted to ensure that the legal business name (LBN) and employer identification number (EIN) listed with NPPES is accurate and consistent with information on file with the IRS.

CMS has mailed letters to organizational (Type 2) health care providers with an EIN/LBN combination on file with NPPES that is different from the information maintained by the IRS. Providers who receive a letter from CMS should update their LBN and/or EIN in NPPES immediately, as CMS has indicated the NPI in NPPES will be deactivated for all providers who are unable to produce information that matches IRS data.

Please be advised that BCBSIL will deactivate any NPI that is deactivated by CMS. If your NPI is deactivated, you will experience problems when submitting electronic claims to BCBSIL or conducting other standard transactions such as claim status, benefits and eligibility inquiries.

To View or Update your NPI data in NPPES, go to the NPI Registry at https://nppes.cms.hhs.gov. For more information about the NPI, go to the CMS Web site at www.cms.hhs.gov/NationalProvIdentStand. You may also continue to visit the NPI section of our Web site – just click on the NPI logo to gain access to a variety of online tools and resources, such as our NPI Communications Library, Frequently Asked Questions, an NPI Glossary and more!