NPI Validation is a service that validates the National Provider Identifier (NPI) status on National Plan & Provider Enumeration System or NPPES (also called CMS Data Dissemination).
NPI Validation returns a monitoring result on the status of the NPI number specifically and does not comment on a provider's exclusion status. Exclusion Monitoring is a monitoring service returning a result for any exclusions tied to the provider or vendor and does not comment on the provider's or vendor's NPI validation status. Adding NPI data can help further identify a provider/entity during exclusion monitoring, in the same way, adding a DOB or home address helps further identify a provider/entity during exclusion monitoring.
If a provider/entity has NPI Validation monitoring, we always return a monitor record result in Passport for the NPI added - similar to License Verification or SSDMF.
The following severities are available for NPI validation in Passport:
Active: Green Result Status. NPI is found on NPPES and the status is active. The alert result will display the detailed provider data that NPPES maintains on Active NPIs including information like name, address, and other practice information.
- DeActivated: Red result Status. NPI is found on NPPES and the status is deactivated. The alert result will display only the minimal data that NPPES maintains on DeActivated NPIs, the deactivation date.
- Not Found: Red result status. NPI cannot be found on NPPES at all.
- Passport does not allow entry of an NPI outside of the 10-digit standard NPI format.