Discussion – NPI Numbers and FNP Practice

Discussion – NPI Numbers and FNP Practice

Advanced practice nursing (APN) provides an avenue for nursing practice advancement and increases participation in nursing care and the clinical decision-making process. As a future FNP, I believe the MSN-FNP program will prepare me for greater participation in nursing care and independence in delivering high-quality care to all. The Center for Medicare and Medicaid Services (CMS) requires that healthcare providers from diverse healthcare cadres have a National Provider Identifier number for standardizing provider identification during electronic transactions, claims processing, and billing (Harrison et al., 2020). Consequently, all HIPAA-covered entities must obtain an NPI for the sake of handling protected health information. Likewise, one must have an NPI number before enrolling with Medicare.

I intend to obtain an APN NPI number for Medicare billing when I start practicing as an independent FNP. This will allow me to order medications and other medical supplies, make claims, and perform any other transaction outlined by the Health Information Portability and Accountability Act (HIPAA). There are several modalities to use to obtain an NPI. The first method is an online application through the National Plan and Provider Enumeration System (NPPES) website. The platform allows providers to create and manage their accounts and complete the right registration in an Identity and Access website that comes as a pop-up in the NPPES platform. One can also obtain an NPI number by applying via mail. In this case, one needs to download, print, and complete an application form in hard copy and subsequently mail it to the NPI Enumerator address (CMS, 2024). I will consider either of these options based on the suitability at the time.

The California Board of Registered Nursing (CBRN) outlines the scope of practice for APRNs and their prescription practices. As per the CBRN’s provisions on APRNs, one must have a valid RN license recognized by the state, possess a graduate degree in nursing, master’s degree in nursing, or a post-graduate degree in a clinical field related to nursing, and satisfactorily complete an NP program recognized by the state. California is a full practice authority (FPA) state. This means that APRNs, licensed by the state, can practice independently without contractual physician supervision. Likewise, NPs can order, prescribe, dispense, and administer schedules II-IV controlled substances (Munday, 2023).

My area of practice is family nursing. Family Nurse Practitioners (FNPs) assess, diagnose, and treat diverse health conditions across the lifespan. This includes but is not limited to performing physical examinations, ordering appropriate laboratory and diagnostics, interpreting results, and starting patients on treatments. Subsequently, certification in healthcare leadership and management is one of the content areas integral to family nursing practice. Healthcare Management and Leadership certifications can be obtained online from various learning institutions and leadership institutes. The certification expands nurses’ foundation in healthcare administration by imparting to them skills in advocacy, communication, ethics, and human resources valuable in interpersonal relations.

Leadership and management skills are particularly valuable to FNP practice. They allow FNPs to establish meaningful relationships with their clients and other healthcare professionals involved in multidisciplinary care (Alilyyani et al., 2024). Likewise, leadership and management skills may help FNPs to navigate the dynamic landscape of the healthcare environment, maintaining high standards of care to promote productivity and improve patients’ health and clinical outcomes. To obtain a certification in healthcare leadership and management, one needs to identify a credible provider, apply, make necessary payments, and earn the certificate. Several online programs and tertiary institutions exist that provide leadership certificates for FNPs. These programs can be accessed online through a simple web search. The cost of certification varies from 200 dollars for online certification programs to over 3,500 dollars for post-graduate certificate courses. The certification programs are provided as one-time courses and do not have renewal requirements.

References

Alilyyani, B., Althobaiti, E., Al-Talhi, M., Almalki, T., Alharthy, T., Alnefaie, M., Talbi, H., & Abuzaid, A. (2024). Nursing experience and leadership skills among staff nurses and intern nursing students in Saudi Arabia: A mixed methods study. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-01750-1

CMS. (2024, March 22). How to apply. CMS.gov. https://www.cms.gov/medicare/regulations-guidance/administrative-simplification/how-apply

Harrison, J. M., Germack, H. D., Poghosyan, L., & Martsolf, G. R. (2020). Surveying primary care nurse practitioners: An overview of national sampling frames. Policy, Politics, & Nursing Practice, 22(1), 6–16. https://doi.org/10.1177/1527154420976081

Munday, R. (2023, March 23). California expands nurse practitioner practice authority. NurseJournal.org. https://nursejournal.org/articles/california-expands-nurse-practitioner-practice-authority/

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Week 7: Discussion Question – NPI Numbers
Discussion Prompt

Discussion – NPI Numbers and FNP Practice

Describe briefly how and when you will obtain an advanced practice nursing NPI number for Medicare billing as a nurse practitioner through the National Plan & Provider Enumeration System (NPPES), using resources like https://nppes.cms.hhs.gov/#/.
Additionally, share a brief synopsis of your specific state’s licensing/certificate (MY SPECIFIC STATE IS CALIFORNIA) requirements for APRN prescribing, such as a furnishing license, DEA, or prescription authority, and clarify if collaborating physician review is needed to co-prescribe or review APRN prescriptions.
Lastly, discuss briefly a specific certification or license add-on relevant to your hopeful area of practice, explaining its importance. For example, this could be a DMV/DOT certificate, a buprenorphine waiver, an aesthetic skill, or death certification training. The discussed skill or certification must be within the scope of an NP and outside the scope of an RN. Discuss steps needed to obtain the certification or skill, cost, and any renewal requirements.