NPI Requirements for Medicare DMEPOS Suppliers

The Centers for Medicare and Medicaid Services (CMS) will be linking Medicare provider numbers with National Provider Identifier (NPI) numbers. Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) suppliers are required to obtain an NPI for every location. The only exception to this requirement is the situation in which a Medicare DME supplier is a sole proprietor. A sole proprietor is eligible for only one NPI (the individual’s NPI) regardless of the number of locations the supplier may have.

Federal regulations require the unique enumeration of every location of a Medicare DME supplier regardless of how claims are submitted. TRICARE is following Medicare’s guidelines for DMEPOS suppliers.

For more information on Medicare Subpart Expectations, please visit the Medicare Subpart Guidance Paper at http://www.cms.hhs.gov.