WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #3421
Provider Identification
Health Care Providers
Health care providers are required to indicate an NPI (National Provider Identifier) on enrollment applications and electronic and
paper transactions submitted to ForwardHealth.
The NPI is a 10-digit number obtained through the NPPES (National Plan and Provider Enumeration System).
Providers should ensure that they have obtained an appropriate NPI prior to beginning their enrollment application. There are two
kinds of NPIs:
• Entity Type 1 NPIs are for individuals who provide health care, such as physicians, dentists, and chiropractors.
• Entity Type 2 NPIs are for organizations that provide health care, such as hospitals, group practices, pharmacies, and home
health agencies.
It is possible for a provider to qualify for both Entity Type 1 and Entity Type 2 NPIs. For example, an individual physical therapist
may also be the owner of a therapy group that is a corporation and have two Wisconsin Medicaid enrollments — one enrollment
as an individual physical therapist and the other enrollment as the physical therapy group. A Type 1 NPI for the individual
enrollment and a Type 2 NPI for the group enrollment are required.
NPIs and classifications may be viewed on the NPPES website. The federal CMS (Centers for Medicare and Medicaid
Services) website includes more information on Type 1 and Type 2 NPIs.
Health care providers who are federally required to have an NPI are responsible for obtaining the appropriate certification for
their NPI.
Non-Healthcare Providers
Non-healthcare providers, such as SMV (specialized medical vehicle) providers, personal care agencies, and blood banks, are
exempt from federal NPI requirements. Providers exempt from federal NPI requirements are assigned a Medicaid provider
number once their enrollment application is accepted; they are required to indicate this Medicaid provider number on electronic
and paper transactions submitted to ForwardHealth.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
16944a86dd3b105c1c64ef965d419cb8b44970bd06ecd02ef30562d8c2a6e3c9
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.