Health Information Management

Topic: Data dissemination underway--Edit information to ensure integrity

HIM-HIPAA Insider, September 11, 2007

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CMS began disclosing National Plan and Provider Enumeration System (NPPES) data via the Internet on September 4. The data, which is disclosable under the Freedom of Information Act (FOIA), is available online in the following two forms:

  • A query-only database, known as the National Provider Identifier (NPI) registry
  • A downloadable file

Remind providers that as of September 3, Medicare carriers and durable medical equipment Medicare Administrative Contractors began transitioning their systems to start rejecting claims if the NPI and legacy provider identifier cannot be found on the Medicare crosswalk.

Encourage providers to review their data and visit the CMS Web site to view what the downloadable file looks like. CMS has posted several documents to help providers understand the database, including a "Read Me" file, Header File, and Code Value document for the downloadable file, all on the CMS NPI Web site at http://www.cms.hhs.gov/NationalProvidentStand/06a_DataDissemination.asp.

Providers can verify NPPES data at https://nppes.cms.hhs.gov.



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