National Provider Identifier (NPI)

NPI is mandated to be used on electronic claims on and after May 23, 2008.  ODJFS has and will continue to deny electronic claims that are missing an NPI in the pay to and rendering provider fields on the 837 electronic claim transactions. Although the legacy is not required, ODJFS will continue to accept claims that contain both NPI and legacy in the pay to and rendering fields of the electronic claim until further notice. If a claim rejects because the NPI is not in the ODJFS crosswalk, the trading partner should notify the provider of the rejection.  Providers who are notified of claim rejections because their NPI is not found in the ODJFS crosswalk, should call the ODJFS IVR at 800-686-1516 to share their NPI.  ODJFS will update the crosswalk, and the provider may resubmit the claim to ODJFS for adjudication. Providers can also call the IVR to verify the correct NPI to legacy match prior to claims submission