How to Get a Medicare Provider Number in Florida

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By Shawn Hayes

Medicare is a federally funded, state-dispensed social health insurance program for citizens 65 years or older. Physicians who participate in the Medicare program are issued a unique identification number, called a National Provider Identifier, which is required for Medicare to pay participants’ claims. Occasionally, a claim form will find its way to Medicare without the requisite NPI, preventing Medicare from paying the claim promptly. If this happens, you will need to locate your physician’s NPI quickly to prevent delays or potentially being held liable for the full amount of your bill.

Online

Visit the government’s Medicare website.

Click on the option titled “Doctors” under “Resource Locator” on the top main menu of the front page. Click on “Physicians Directory” on the next screen.

Select the option for “Primary care physician” if you are looking up the NPI of your family doctor. Select the option for “Specialist” if you are looking up the NPI of a referred doctor or specialist.

Limit your results by entering the physician’s gender, practice or primary specialty, or zip code using the “Advanced Search” option. If you know the physician’s first and/or last name, enter it for even more targeted results. Skip this step if you do not have this information on hand.

Check the option for “Accepts Medicare” at the bottom of page to reduce the number of search results you receive. Click the “Search Now” button to begin your search.

Review your search results on the next screen. Click the link for your physician’s name to review his profile. If you are positive the profile belongs to your physician, locate his NPI at the bottom of the screen and write the number down. If it is not your physician, click the “Back to Search Results” button to see more options, and continue reviewing profiles until you find the correct NPI.

By Telephone

Contact the Medicare Assistance Hotline toll-free at 800-633-4227, available 24 hours a day. Ask to speak with a representative who can look up National Provider Identifier numbers.

Provide the representative with the name, gender, address, zip code and/or primary specialty of the physician you need to locate. If you do not have all of this information, provide what you have. Use your original Medicare claim form for the physician’s information if you do not already know it.

Browse through the results with the representative until she locates the correct physician. Request the physician’s NPI and write it down. The representative may also be able to update your Medicare claim with the NPI if you have your claim information on hand.

Shawn Hayes

Contributor