How do I find out if an ordering provider is eligible to order items or services for Medicare beneficiaries?

Question:

How do I find out if an ordering provider is eligible to order items or services for Medicare beneficiaries?

Answer:

The three basic requirements for ordering/referring are:

1. The ordering/referring provider’s National Provider Identifier (NPI) must belong to an individual physician/NPP. NOTE Organizational NPIs do not qualify and cannot order/refer.

2. The physician/NPP must be enrolled in Medicare in either an “approved” or an “opt-out” status.