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A0100: Facility Provider Numbers

A0100: Facility Provider Numbers 

Image removed. 

Item Rationale 

Image removed.Allows the identification of the facility submitting the assessment. 

Coding Instructions 

Enter the facility provider numbers: 

National Provider Identifier (NPI). 

CMS Certification Number (CCN) – If A0410 = 3 (federal required submission), then A0100B (facility CCN) must not be blank. 

State Provider Number (optional). This number is assigned by the State survey agency and provided to the intermediary. When known, enter the State Provider Number in A0100C. Completion of this is not required; however, your State may require the completion of this item. 

 

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Manual Version 1.18.11    October 2023