Skip to main content

NPI Exemption Notification Form

Medical - National Provider Identifier (NPI) Exemption Notification Form

If you are exempt from the NPI regulation, you must provide us the following information so that we can continue to process your transactions without an NPI after the HIPAA compliance date. 

Be sure to include a contact name and phone number so we can follow up if we require any additional information. 

All fields marked with a RED asterisk (*) are required in order to proceed.

1 of 2


1) Information
2 of 2

Contact Information


2) Contact Information

Brief explanation of why you are identified in transactions in the locations usually used to identify health care providers, but are not considered a health care provider according to the NPI regulations


Please check this form carefully before clicking on the "Submit" button. Some browsers will not keep your information, and you will have to re-type all of it if you miss filling in any of the required fields.

Your request has been sent successfully if you receive a confirmation after clicking the "Submit" button.

JavaScript is required

In order to have the best experience on, Javascript needs to be enabled.
Learn how to change your browser settings to enable Javascript.

You are now leaving the Aetna website

Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.

Continue >