The following tables list the loops and segments that are designated for the NPI. This is only a guide for locating the NPI and is not intended to replace the Companion Guides (CG’s). Updated CG’s are available on the eMedNY.org web site on the NYHIPAADESK tab. The following information is not for use with ePACES or paper claim forms. At the present time the NYS Medicaid Provider ID and Locator Code are still required for claims processing.
NYSDOH and CSC will notify providers when the eMedNY system is ready to receive the NPI as the primary provider identifier.
The 837I Institutional claim transaction can have NPI data mapped from 8 different locations. The NPI data will be captured in the NM1 Provider Name segment of the following Loops when NM108 = (XX) Qualifier and NM109 = (Healthcare Financing Administration National Provider Identifier).