This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
Dataset Information
Subject
Transparency and Disclosure
Jurisdiction
Federal
Data Provider
National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source
download.cms.gov
Dataset Details
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).
All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).
Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.
This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.
Statistics
The taxonomies with the most number of NPI provides are Student in an Organized Health Care Education/Training Program (3.95%), Pharmacist (3.61%), Mental Health Counselor (3.43%), Clinical Social Worker (3.28%), Physical Therapist (3.27%). Other popular taxonomies are in the categories of physician, dentist, nurse, and counselor. The number of NPI providers in each state is roughly consistent with the state population, with California (12%), New York (7.6%), Florida (6.7%), Texas (6.5%) and Ohio (4.10%) on the top list. The following cities have the most number of providers: New York (2.2%, including Brooklyn), Houston (0.97%), Chicago (0.90%), Los Angeles (0.88%), Las Vegas (0.72%), Miami (0.72%) and San Diego (0.64%). At the first years when NPI was introduced (2005-2008), large numbers of NPIs are enumerated each year, especially in 2006. In the recent years, the number of NPI providers has grown at a steady rate year over year. We expect to see more providers being assigned NPIs in the coming years.