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Back  RFI # 553: Entity Reporting

Formal vs. Informal Help Informal Formal

Submitter

Barbara Sesny

Description

What constitutes an entity as a person vs a non-person? Can a person be identified by an EIN or can they only be identified with an SSN? Likewise, can a person be identified by an organizational NPI or must they always use an individual NPI?

Response

As used in NM1 name segments in the claim transaction, a value of 1, person, in NM102 indicates an individual person and a value of 2, non-person, is an entity, group, or organization which could include a one-person legal entity. An individual person will have an associated SSN, and not an EIN. Conversely, a non-person entity can have an EIN but would not have an SSN. Any questions about NPI enumeration should be directed to the organizations that have authority over these identifiers.
Submission 4/30/2007
Status Date 6/18/2007
Status F - Final
Primary References
Document 004010X098A1
Section3
Page86
Set ID837
Table1
Loop2010AA
Segment Position015
Segment IDNM1
Element Position09
Industry NameIdentification Code