Oxford Health Plans > Message > National Provider ID

Oxford is collecting NPI information

The Health Insurance Portability and Accountability Act (HIPAA) mandates the adoption and use of a standardized National Provider Identifier (NPI) for all health care providers. In compliance with HIPAA, all "covered" health care providers and organizations must obtain an NPI for identification purposes in standard transactions. The final compliance date for all covered entities, except small health plans, is May 23, 2007.

Oxford is collecting NPI and related information from physicians, health care professionals, facilities and ancillary providers that have been enumerated. Providers and organizations who have already notified UnitedHealthcare of their NPI do not need to also inform Oxford (and visa versa). Information received by both platforms will be cross-walked by compliance deadlines.

The NPI information we are collecting includes:

For Both Individual (Type 1) Providers and Organizations (Type 2) Providers:

  • NPI (or multiple NPIs where applicable) - your 10-digit National Provider Identifier
  • NPI Issue Date - date you received your NPI (MM/DD/YYYY)
  • NUCC Taxonomy Code(s) - a ten alpha-number character entered on the NPI application to designate your provider type designation or specialty for use in HIPAA transactions. Please include each NUCC Taxonomy Code listed on your NPI application
  • Name - the name you used on the NPI application
  • Tax Identification Number - the tax identification number tied to the NPI information being submitted on the form.

Additionally, for Organization and Facility (Type 2) Providers that have more than one NPI, include the following information:

  • Organization or Subpart Name - the organization or subpart name associated with the NPI
  • Basis for NPI (rationale for each) using one of the basis codes shown here and the corresponding information:
  • Basis Codes
    • C = Entity whose name is on the W-9 and Tax ID that the NPI was based on.
    • T = Tax Identification Number (TIN) and Provider Name that the NPI was based on, where the provider is not the same on the W-9.
    • L = License or Certification (include state or state code and license number that the NPI was based on).
    • X = Taxonomy code that the NPI was based on.
    • P = Place of Service or by location (provide the street address that the NPI was based on).
    • D = Department name that the NPI was based on.
    • O = (Other) Describe basis for NPI; specify details for selecting other.

NPI Submission

Submit NPI information to Oxford on provider letterhead or by completing a Provider Demographic Update form
(sections I and III)*. The form is available on the Tools & Resources section of Oxford’s provider and facility web sites. Click on Forms under Manage Your Practice and select and download the appropriate form to your desktop. Completed forms and provider correspondence can be sent to Oxford via:

  • Email: OX_HPDemo@uhc.com

             OR

  • Fax OXHP Demo: 866-561-3966

    Please continue to check provider and facility sites on www.oxfordhealth.com for general NPI information and updates on our NPI implementation plans.

    * For purposes of informing us of NPI, only sections I and III of the Provider Demographic Update form are necessary. Please complete section II if you also need to update us about other practice/organization changes.