Exclusive Provider Organization - 302F00000X
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(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
| Field | Value |
|---|---|
| Code | 302F00000X |
| Grouping | Managed Care Organizations |
| Classification | Exclusive Provider Organization |
| Specialization | — |
| Category | Non-Individual |
NPI Registrations
2.7K NPIs are registered under this taxonomy code nationwide.
The table below splits that total by NPI type — Type 1 covers individual practitioners, Type 2 covers organizations and facilities — followed by the five states with the most NPIs registered under this taxonomy code.
| Field | Value |
|---|---|
| Registered NPIs | 2.7K |
| Type 1 (Individual) | 149 |
| Type 2 (Organizational) | 2.5K |
Frequently Asked Questions
References
- 1.Health Care Provider Taxonomy Code Set. National Uniform Claim Committee (NUCC). Retrieved Aug 11, 2026.The official registry of provider taxonomy codes used to classify individual and organizational health care providers by specialty on standard transactions such as claims, NPI enrollment, and prior authorization requests.
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