Provider Enrollment National Provider Identifier (NPI) Entry Enhancement, CR 122156

Mar 05, 2024

NPIs, i.e. Pay To, Rendering, and Non-Billing, Ordering, Prescribing, and Referring (NOPRs) are now checked against the National Plan and Provider Enumeration System (NPPES) directory to see if there is a match. If there is not a match, the NPI will not be allowed entry. Providers should review the information entered to ensure accuracy. If the system still will not accept the NPI, providers should wait at least five business days and try again.

Providers are also no longer allowed to manually change the name of their organization or the name of a rendering provider. Providers looking to change those names must do so with NPPES. The MaineCare system will reflect that change within a week of approval from NPPES.

If there are questions regarding this change, please reach out to the Provider Enrollment Manager, Kenneth Jamison (KJ).