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Do I enter myself as an Individual or Organization under Billing Provider info?

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4 comments

  • Wendy Belding

    “If you are an individual who is a health care provider and who is incorporated, you may need to obtain an NPI for yourself (Type 1) and an NPI for your corporation or LLC (Type 2).”

    https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/downloads/enrollmentsheet_wwwwh.pdf

    We use the Individual Name and NPI Type-1 for boxes in 24-J (Rendering Provider) and the Corp Name and NPI Type-2 for boxes 32 and 33.

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  • Rachel Dushenko

    Thanks for your reply. I do have an LLC but I am not incorporated. I was told by carefirst I should only use NPI Type 1. So it sounds like that means I should just select “individual “ . Is that correct ?

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  • Wendy Belding

    I don’t see how that could work. The type-1 NPI won’t match an EIN/Business Name. And, if you bill as an individual using your SSA #/Personal Name, then what’s the point of having an LLC? Is your liability even limited now? And, the earnings would go on a 1099 to your SSA, not to your EIN. But I’m NOT a tax or legal expert: you will likely need to consult with one or both.

    We started an “S Corp.”

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  • Cody Heath

    Rachel, I was lead to believe the same, that we do not need a type 2 NPI.  If you change the information linked to the NPI through the website https://nppes.cms.hhs.gov/#/ then the information for EIN, business name, address, etc would match. 

    As for you original question: I came here searching for the same answer. 

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