Do You Need an NPI in Assisted Living?

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Thinking about starting an assisted living business and wondering if you need an NPI (National Provider Identifier)? You’re not alone! Many new owners are unsure whether this number is necessary—or if it even applies to them.

The truth is that not every assisted living facility needs an NPI. But in some cases, having one can be essential. In this guide, we’ll break down what an NPI is, when you need it, and how to apply it if required.

Let’s get started! 🚀

Check out this video, too;

 

What Is an NPI?

An NPI (National Provider Identifier) is a unique 10-digit number assigned to healthcare providers and organizations by the Centers for Medicare & Medicaid Services (CMS). It helps standardize healthcare transactions, especially for billing Medicare, Medicaid, and private insurance.

But here’s the key question…

Does an assisted living facility need an NPI?


Do Assisted Living Facilities Need an NPI?

Most assisted living facilities (ALFs) DO NOT need an NPI because they typically operate as residential care homes, not medical providers. However, there are a few exceptions:

If your ALF provides medical services (e.g., skilled nursing, home health, or therapy services), you may need an NPI.
If you plan to bill Medicare or private insurance, you’ll likely need an NPI.
If you partner with healthcare providers who require it for referrals, having an NPI could be beneficial.

An NPI is not required for most standard assisted living businesses focused on room, board, and personal care.


When Does Your Assisted Living Business Need an NPI?

If your business falls into any of these categories, you should consider applying for an NPI:

🔹 Home health agencies offering skilled nursing or therapy.
🔹 Memory care units that provide medical services.
🔹 Assisted living facilities with an in-house physician or medical staff.

Still unsure? Talk to a healthcare attorney or consultant to determine whether your facility needs an NPI.


How to Apply for an NPI (If You Need One)

If your business does require an NPI, here’s how to apply:

1️⃣ Visit the National Plan and Provider Enumeration System (NPPES) website: https://nppes.cms.hhs.gov
2️⃣ Create an account and fill out the online application.
3️⃣ Provide your business details, including your Tax ID and business structure.
4️⃣ Submit the application—processing usually takes a few days.
5️⃣ Receive your NPI number and keep it for future billing or credentialing.


Next Steps: What Should You Do?

🚀 If you DON’T need an NPI: Move forward with your business and focus on licensing, marketing, and operations.
🚀 If you DO need an NPI: Apply now to avoid delays in insurance billing and provider partnerships.
🚀 Still confused? Apply for the Assisted Living Investing Mastermind for expert coaching on licensing, regulations, and business setup.

If you need help getting started, make sure you grab our FREE Business Plan Checklist as well to help you start making progress.

Got questions? Drop them in the comments below! ⬇️

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