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NPI

NPI submission

Prospect Medical Group needs to collect your National Provider Identifier (NPI) and related information before the compliance date of May 23, 2007. Please complete the form in its entirety before submitiing.

Entries marked with an asterisk (*) are required to submit the form.

  
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*   (Must be 10 digits to be valid)
  (If applicable)
  (If applicable)
*
You may access information on NPI Taxonomy Codes by going to: http://www.wpc-edi.com/taxonomy/. If entering more than one code, please separate with a comma between each taxonomy code.
*   (mm/dd/yyyy)
  (If applicable)
  (If applicable)
*   (Enter number without dashes. A state license number may be entered if no Tax ID exists.)
  (If applicable)
  (If applicable)
*
The Basis can be the name, TIN, license, taxonomy code, place of service addresses or department in the event that there is more than one NPI for an organization or its subparts.

Click the submit button below to send your form. If you have any questions regarding submitting the NPI form, please call the Provider Relations department at Prospect Medical at 1-800-708-3230, Press 4, then 4 to reach the department.

For additional information regarding NPI, please go to the U.S. Department of Health and Human Services website at: http://www.cms.hhs.gov/NationalProvIdentStand/07_Questions.asp.
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