All MDs in the country now have to have an NPI number. This is supposed to be a unique number that identifies you throughout the nation, presumably so the government knows that we’re qualified to practise medicine and knows where we are at all times.

Unfortunately, there are still some hitches in getting one. What follows is an email sent by a colleague of mine which expresses his frustration with the whole process. It’s also pretty funny.

Sent: Wednesday, October 11, 2006 10:33 AM
To: ‘’
Subject: My NPI number

Hi, I have tried several times to obtain my NPI number from your company. I have previously applied for the NPI number but my application was disallowed because I already had one. My tracking number is YYYYYYYYYYYY.

However, the mailing did not include the NPI number or any information on how to obtain it. In addition, the website did not offer any ways to retrieve this number without first logging in with your NPI number . After many follow-up emails and phone calls I was told that despite giving out (multiple times) my social security number, date of birth and other revealing personal data that my number had already been given out to somebody else (who apparently can get this information on me without divulging their own SSN or DOB and did not even have the audacity to pretend to be me) and that I would have to track her down. Fortunately, although she was elusive, she was not as reticent as your employees were and I succeeded in extracting from her my NPI number. She was under the obviously mistaken notion that this number is not a secret!

Over the past week, I had requested from your company that perhaps someone could divulge my number to me, but it appears this is not the policy of Fox Systems Inc. In addition, it would have been helpful to give me my username and password such that I could log onto the website and view the number myself, but this was never provided nor offered.

During this time, none of the staff at Fox Systems Inc. was able to tell me, email me, fax me, send a letter via certified mail, send via courier, or in any other possible way imaginable divulge the secret 10 digit number that is my NPI number. I have finally tracked that number down (and have shredded the piece of paper that contained it so that no other eyes will ever know my NPI number). I would like to know how I can keep this number a secret in the future since (despite your best attempts) it doesn’t appear that this number is intended or designed to be kept secret. Indeed, it will be passed on to many persons of various security clearances at credentialling agencies, state medical boards, health insurance companies and perhaps even the federal government. I am worried that despite your effort to keep this number secret (including having me give personal data to confirm that it is indeed me that you are not giving the number to over the phone) that this number will not remain a secret for very long. There are no instructions included with the NPI detailing how I am to keep this number a secret in the future. There is the possibility that my number and name will be known to several hundred if not thousands of people in the future will use it in daily practice as part of their job in healthcare to help facilitate billing! As alarming as this is, I was wondering if I can be given a number that changes daily and is generated randomly such that no other person (besides the NPI Enumerator) will ever know my number? This would be of added benefit since I will have a number (but not know what it is in case I may commit Medicare fraud with it) and the NPI Enumerator will have the ability to keep this number forever secret and therefore, not particularly useful to anyone. Alternatively, I could apply for a number on a weekly or daily basis and you could send the NPI number to an address you find at random in the phone book, which is how it appears you do things currently.

I expect that I will not have any reply to this email since I have already emailed several times and have had zero replies.

You have made the process of obtaining this relatively simple number a vastly entertaining and rewarding experience for me. I hope that Fox Systems Inc. will continue to be awarded governmental contracts of such monumental importance as becoming NPI Enumerator in the future. Imagine how effective you’d be at keeping secret something that is actually intended to be kept confidential! Your company is an inspiration to byzantine bureaucracies everywhere, and it is fulfilling to know that the private sector is excelling at what the public sector and had done so well in the past. It is comforting to know that the spirit of Kafka-esque, Soviet-era bureaucracy is alive and well in Fargo, ND. Well done!



P.S. Please include your name, SSN #, DOB and other revealing information to me on responding to this message and I will forward that information and the 10 digit number I decide to give you to ZZZZZ ZZZZZZZ (I don’t know who she is either, but she had my NPI number and I’ll give her yours).