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National Provider Identifier (NPI) for CEPs

What is an NPI?
In 1996, the Health Insurance Portability and Accountability Act (HIPAA) mandated the adoption of a standard, unique health identifier for health care providers. The purpose of the National Provider Identifier (NPI) is to identify a healthcare provider in standard transactions, such as health care claims.

Do I need an NPI as a CEP?
Clinical Exercise Physiologists working in a hospital/clinic based settings are typically filed under the group NPI designation held by their hospital/organization. It is unlikely that a CEP working in this type of setting will have an individual need for an NPI. Professionals billing independently require an individual NPI enumeration code for billing purposes and will find the inclusion of the CEP as beneficial.

My hospital/organization bills for my services as a CEP under a “group” hospital NPI designation. Why should I apply for an “individual” NPI as a CEP?
Inclusion of the Clinical Exercise Physiologist in a national code set of health care providers proves to be another step towards advancement of the profession. It is important to establish a national presence for the CEP profession. It helps to quantify CEPs on a national level thereupon providing a basis for other legislative initiatives for the profession. CEPA is encouraging all qualified candidates to apply.

Who can apply for the NPI?
Any individual who considers themselves a CEP.

I need a taxonomy code for the application - where can I find the listing for the CEP?
It is located under the “Respiratory, Developmental, Rehabilitative and Restorative Service Providers” section of the listings. The code is 224Y00000X.

What is a taxonomy code?
A “taxonomy code” serves to identify the area of specialization of health care providers, for example: chiropractic, dental, dietary, etc. The codes are grouped by provider type and education and training. Taxonomy codes are not used to define services rendered, but rather to define areas of specialty. In order to obtain an NPI designation, one must identify with a specific taxonomy code.

To apply for an NPI and help advance the profession of clinical exercise physiology, click here. For quick application tips, click here or to download the instruction booklet for help in completing your application, click here.