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TMSIS Dataguide Medicaid.gov
Version 3.36.0

SERVICING-PROV-NPI-NUM

Data Element

DE Number

CIP261

System DE Number

CIP.003.261

File Name

CIP - CLAIM INPATIENT

File Segment Number

CIP00003

File Segment Name

CLAIM-LINE-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The NPI of the health care professional who delivers or completes a particular medical service or non-surgical procedure. The Servicing Provider NPI Number is required when rendering provider is different than the attending provider and state or federal regulatory requirements call for a "combined claim" (i.e., a claim that includes both facility and professional components). Examples are Medicaid clinic bills or critical access hospital claims.
Size X(10)
FLF Start Position 294
FLF Stop Position 303
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 10 digits
2. Value must have an associated Provider Identifier Type equal to "2"
3. Value must exist in the NPPES NPI data file
4. Conditional
5. When Type of Claim is in [1,3,A,C], then value must be populated
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CLT213 CLT.003.213 SERVICING-PROV-NPI-NUM CLT00003 CLAIM-LINE-RECORD-LT
COT190 COT.003.190 SERVICING-PROV-NPI-NUM COT00003 CLAIM-LINE-RECORD-OT