PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
the document
for the current year.
National Provider Identifier (Npi) Backdate Form - Colorado
National Provider Identifier (Npi) Backdate Form is a legal document that was released by the Colorado Department of Health Care Policy and Financing - a government authority operating within Colorado.
FAQ
Q: What is the National Provider Identifier (NPI)?
A: The NPI is a unique identification number for healthcare providers.
Q: What is the purpose of the NPI backdate form in Colorado?
A: The backdate form allows healthcare providers in Colorado to request a retroactive effective date for their NPI.
Q: How do I request a retroactive effective date for my NPI?
A: You can request a retroactive effective date by filling out the NPI backdate form in Colorado.
Q: Are there any specific requirements to qualify for a retroactive effective date for my NPI?
A: Yes, there are specific requirements that need to be met in order to qualify for a retroactive effective date. These requirements are outlined in the NPI backdate form.
Form Details:
- Released on November 1, 2020;
- The latest edition currently provided by the Colorado Department of Health Care Policy and Financing;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Colorado Department of Health Care Policy and Financing.
