Medicare AdvantageAdministrativeMedium impact
National Plan and Provider Enumeration System Reminder
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jul 1, 2026
We identified it
Jul 1, 2026
Summary
CMS is reminding Medicare Advantage Organizations to work with contracted providers to review, update, and certify provider information in the National Plan and Provider Enumeration System (NPPES). Providers must ensure all active practice locations are listed with current contact information, remove inactive locations, and formally certify the accuracy of their data in NPPES. Note: NPPES updates do not affect Medicare Fee-For-Service billing.
Action Required
By July 1, 2026: Providers and practice management staff must review and update all provider information in NPPES, including: (1) correcting provider name, mailing address, telephone, fax numbers, and specialty in all modifiable fields; (2) adding all current practice locations where patients are actively seen and can schedule appointments; (3) removing any practice locations no longer in use; (4) certifying the accuracy of all updated information in NPPES. Billing team should coordinate with providers to ensure compliance. Failure to maintain accurate NPPES data may impact patient access to scheduling information and plan directory accuracy for Medicare Advantage enrollees, though it does not directly affect billing claims processing.