HCFA-1500 Box 17b - NPI

On the HCFA-1500 form, Box 17b is used to report the referring, ordering, or supervising provider’s National Provider Identifier (NPI). This is a 10-digit, federally assigned number that uniquely identifies healthcare providers in HIPAA transactions.

Tip: Enter only the provider’s NPI in Box 17b—no qualifier is used here. This field should always contain a valid NPI when applicable.

In our example below, we entered '1234567893' as the referring provider's NPI.

In the X12 837 electronic claim, the NPI appears in the NM109 data element within the NM1 segment of the appropriate provider loop.

• 2310A – Referring Provider
• 2420E – Ordering Provider
• 2310D – Supervising Provider

Key X12 837 Details:
  • NM108: ID Qualifier (XX for NPI)
  • NM109: 10-digit NPI number (e.g., 1234567893)

Sample 837P (5010/4010) – 2310A Referring Provider

Note: Box 17b should always be completed with a valid 10-digit NPI when reporting a provider in Box 17. This ensures proper identification and routing of claims.

Important: All HIPAA-covered entities must use NPIs in electronic transactions. Be sure the NPI reported in Box 17b matches the provider role indicated in Box 17.

For additional information on the X12 837 standard, please refer to the official implementation guides published by X12.

HCFA-1500 Form Box Locations

• HCFA-1500 Box 0 - Carrier Block
• HCFA-1500 Box 1 - Insurance Type
• HCFA-1500 Box 1a - Insured's ID Number
• HCFA-1500 Box 2 - Patient's Name
• HCFA-1500 Box 3 - Patient's Birth Date and Sex
• HCFA-1500 Box 4 - Insured's Name
• HCFA-1500 Box 5 - Patient's Address
• HCFA-1500 Box 6 - Patient Relationship to Insured
• HCFA-1500 Box 7 - Insured's Address
• HCFA-1500 Box 8 - Reserved For NUCC Use
• HCFA-1500 Box 9 - Other Insured's Name
• HCFA-1500 Box 9a - Other Insured's Policy or Group Number
• HCFA-1500 Box 9b - Reserved For NUCC Use
• HCFA-1500 Box 9c - Reserved For NUCC Use
• HCFA-1500 Box 9d - Insurance Plan Name or Program Name
• HCFA-1500 Box 10 - Is Patient's Condition Related To
• HCFA-1500 Box 10d - Claim Codes
• HCFA-1500 Box 11 - Insured's Policy Group or FECA Number
• HCFA-1500 Box 11a - Insured's Date of Birth and Sex
• HCFA-1500 Box 11b - Other Claim ID
• HCFA-1500 Box 11c - Insurance Plan Name or Program Name
• HCFA-1500 Box 11d - Is There Another Health Plan
• HCFA-1500 Box 12 - Patient's or Authorized Person's Signature
• HCFA-1500 Box 13 - Insured's or Authorized Person's Signature
• HCFA-1500 Box 14 - Date of Current Illness, Injury, Pregnancy (LMP)
• HCFA-1500 Box 15 - Other Date
• HCFA-1500 Box 16 - Dates Patient Unable to Work in Current Occupation
• HCFA-1500 Box 17 - Name of Referring Provider or Other Source
• HCFA-1500 Box 17a - Other ID
• HCFA-1500 Box 17b - NPI [You are Here]
• HCFA-1500 Box 18 - Hospitalization Dates Related to Current Services
• HCFA-1500 Box 19 - Additional Claim Information
• HCFA-1500 Box 20 - Outside Lab Charges

Grab a sample of the HCFA-1500 claim form here - HCFA 02/12 Claim Form