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Important Reminder on Maintaining NPPES Accuracy

Date: 09/26/22

A Message for Providers. Please share with your administrative team.

Reminder: Update and Certify Provider Data in CMS’s National Plan & Provider Enumeration System (NPPES)

Because you're a valued provider partner, we’d like to remind you to review your National Provider Identifier (NPI) data in National Plan & Provider Enumeration System (NPPES) as soon as possible to ensure that accurate provider data is displayed. As you may know, providers are legally required to keep their NPPES data current.

Centers for Medicare & Medicaid Services (CMS) is also encouraging health plans to use NPPES as a resource for our online provider directories. By using NPPES, we can decrease the frequency by which we contact you for updated directory information and provide more reliable information to our members.

If the NPPES database is kept up to date by providers, our organization can rely on it as a primary data resource for our provider directories, instead of calling your office for this information. With updated information, we can download the NPPES database and compare the provider data to the information in our existing provider directory to verify its accuracy.

When reviewing your provider data in NPPES, please:

  • Update any inaccurate information in modifiable fields including provider name, mailing address, telephone and fax numbers and specialty, to name a few.
  • Make sure to include all addresses where you practice and actively see patients and where a patient can call and make an appointment.
  • Do not include addresses where you could see a patient, but do not actively practice.
  • Remove any practice locations that are no longer in use.

Once you update your information, you will need to confirm it is accurate by certifying it in NPPES. If you have any questions pertaining to NPPES, you may reference NPPES help.

If you have questions or need support, please contact Provider Services at:

  • Ambetter from Sunflower Health Plan (Marketplace): 1-844-518-9505 (TTY 711)
  • Wellcare By Allwell (Medicare Advantage):
    • HMO 1-855-565-9519
    • HMO D-SNP 1-833-402-6707
    • PPO 1-833-696-0634
    • TTY: 711