Transcription of Provider Specialty Type of Practice Codes
1 PHYSICIAN CODES01 General Practice94 interventional Medicine02 General Surgery98 Gynecology Oncology03 Allergy/Immunology99 Unknown Physician Specialty04 Otolaryngology05 AnesthesiologyNON-PHYSICIAN Provider CODES06 Cardiology42 Certified Nurse Midwife07 Dermatology43 Certified Registered Nurse Anesthesiologist 08 Family Practice (CRNA), Anesthesia Assistant10 Gastroenterology49 Ambulatory Surgical Center (formerly 11 Internal MedicineMiscellaneous) 12 Osteopathic Manipulative Therapy50 Nurse Practitioner13 Neurology62 Independently-Billing Psychologist14 Neurosurgery64 Independently-Billing Audiologist16 Obstetrics/Gynecology65 Independently-Practicing Physical Therapist18 Opthamology67 Occupational Therapist - Private Practice19 Oral Surgery (Dentist Only)
2 68 Clinical Psychologist20 Orthopedic Surgery80 Licensed Clinical Social Worker22 Pathology88 Unknown Supplier/Provider24 Plastic and Reconstructive Surgery89 Certified Clinical Nurse Specialist25 Physical Medicine and Rehabilitation96 Optician26 Psychiatry97 Physician Assistant28 Colorectal Surgery (formerly Proctology)29 Pulmonary DiseaseSUPPLIER CODES30 Diagnostic Radiology45 Mammography Screening Center33 Thoracic Surgery47 Independent Diagnostic Testing Facility34 Urology51 Medical Supply Co. w/ Certified Orthosist35 Chiropractic52 Medical Supply Co. w/ Certified Prosthesist36 Nuclear Medicine53 Medical Supply Co.
3 W/ Certified Prosthesist-Orthosist37 Pediatric Medicine54 Medical Supply Company38 Geriatric Medicine55 Individual Certified Orthosist39 Nephrology56 Individual Certified Prosthesist40 Hand Surgery57 Individual Certified Prosthesist-Orthosist41 Optometry58 Individual Supplier44 Infectious Disease61 Voluntary Health or Charitable Agencies 46 Endocrinology63 Portable X-Ray Supplier48 Podiatry59 Ambulance Service Supplier66 Rheumatology60 Public Health or Welfare Agencies 76 Peripheral Vascular Disease(Federal , State & Local)77 Vascular Surgery 69 Independently-Billing Clinical Laboratory78 Cardiac Surgery87 All Other Supplier ( , Drug Stores, 79 Addiction MedicineDepartment Stores)81 Critical Care (Intensivists)
4 88 Unknown Supplier/Provider82 Hematology95 Independent Psysiological Laboratory83 Hematology/Oncology84 Preventative MedicineGROUP Practice CODES85 Maxillofacial Surgery70 Multispecialty Clinic or Group Practice86 Neuropsychiatry90 Medical Oncology91 Surgical Oncology92 Radiation Oncology93 Emergency MedicineType of Practice Codes100 PHYSICIAN110 HOSPITAL BASED PHYSICIAN200 INDEPENDENT LABORATORY300 GROUP PRACTICE400 CLINIC500 SUPPLIERPROVIDER Specialty & TYPE OF PRACTICENote: Clin ic co de 7 0 is u sed only for t hose grou ps co mpo sed ofp hys icia ns with mixe d (t wo or mo re) s pec ialt i es.
5 For s ingl especialty groups, use the code applicable for that Specialty whenphys icia n me mbers ar e all of th at one speci alty. Do n ot us especial ty c ode 70 for sin gle s pec ialt y gr oups.
