Showing posts with label PAC ID. Show all posts
Showing posts with label PAC ID. Show all posts

April 18, 2023

How to Use Physician Compare to Extract Free Physician Information

Physician Compare Website
The Physician Compare website is a common and free way to acquire very basic physician data. Not only can you look up information on specific providers using the Physician Compare search tool, you can also download the physician and other clinician data as a set of CSV files. The files contain clinicians' NPI number, name, credentials, practice address, phone number, and specialties, along with some other useful data.

The Physician Compare data on the facility affiliations of the doctors and clinicians, is very sparse, and doesn't even list the name of the facility, only its CCN identifier (CMS Certification Number) and PAC ID (PECOS Associate Control ID). For hospital and other facilities' names, address, and other data, you'll have to search and download numerous other files on the CMS website. CarePrecise acquires these from more than a dozen separate files. Alternatively you can purchase the CarePrecise Advanced dataset that includes all of the clinicians' data plus the facilities' data.

Free Physician Data

Within the free Physician Compare data is the Doctors and Clinicians National Downloadable File, which contains the following fields. The file is too large to be used in Excel, with its 1,048,576-row limit. You will need software that can accept more than that number of records, and a way to integrate it with the facility data in the next section, such as a SQL database, Microsoft Access, FileMaker Pro, or similar relational database software environment. (CarePrecise offers it all in an easy-to-use Microsoft Office format.)

  • NPI (national Provider Identifier number)
  • Individual's PAC ID
  • Individual's Medicare Enrollment ID
  • Last Name, First Name, Middle Name, Suffix
  • Gender
  • Credential(s)
  • Medical school (for some)
  • Graduation year (a useful means of inferring approximate age)
  • Primary specialty
  • Secondary specialties
  • Whether the clinician offers telehealth services
  • Name of the group the clinician works with
  • Number of clinicians in the group
  • Practice address fields
  • Phone number
  • Whether the clinician accepts Medicare's approve amount as full payment
  • Whether the affiliated group accepts Medicare's approved amount as full payment
  • Refence Address ID, indicating the specific suite within the same practice address building

Free Hospital and Other Facility Affiliation data

The Doctors and Clinicians Facility Affiliations file, which indicates the CCN numbers of hospitals and other medical facilities the doctors are affiliated with, contains these fields:

  • Clinician's NPI number
  • Clinician's Individual PAC ID
  • Clinician's name fields
  • Facility type (hospitals, long-term care, rehab, dialysis, etc.)
  • CCN number of the facility
  • CCN number of the parent/primary hospital where the clinician provides service

The file doesn't include the name or address of the facility. This file is too large to be used in Excel, which has a limitation of 1,048,576 rows.

Other files available in the Physician Compare download include:

  • Doctors and Clinicians Quality Payment Program PY 2021 Clinician Public Reporting: Overall MIPS Performance
  • Doctors and Clinicians Quality Payment Program PY 2021 Group Public Reporting: MIPS Measures
  • Doctors and Clinicians Quality Payment Program PY 2021 Group Public Reporting: Patient Experience
  • Doctors and Clinicians Quality Payment Program PY 2021 Virtual Group Public Reporting
  • Doctors and Clinicians 2020 Clinician Utilization Data

None of these files include licensed data, such as board certification or residency information.

Conclusion

There is a lot of useful free information the Physician Compare downloadable files, but pulling it together with the more robust data in the NPI registry  – the National Plan and Provider Enumeration System (NPPES) file – is more than a little bit difficult, requiring special methods for dealing with the 7.5 million-record file, and some relational database chops, as well. The hospital affiliations include the CCN number, but not the name, address, phone, etc. of the facilities, requiring additional search and extraction steps. For users who have mastered using these free files but need these additional data, CarePrecise offers data packages that can easily be linked to the Physician Compare date, or they can skip downloading and processing the free files themselves and go to CarePrecise for the combined ready-to-use dataset.

For deeper data on the wide range of U.S. healthcare facilities, CarePrecise also offers the Authoritative Hospital Database, with data on more than 50,000 facilities.

CarePrecise offers its customers free guidance in finding free, downloadable healthcare provider data to fill a wide variety of needs, and works with many research programs that require highly specialized healthcare provider information.

March 23, 2023

CCN and PAC ID to NPI: Crosswalk between the NPI Registry and Hospital and Group Records

The federal Centers for Medicare and Medicaid Services (CMS) publishes a wide range of information on U.S. hospitals, which all carry the unique identifier, the CCN number (CMS Certification Number)*. On the other hand (which often seems to not know what its counterpart is doing), CMS also publishes the frequently updated NPPES database (National Plan and Provider Enumeration System), commonly known as the NPI Registry, which uses the NPI number (National Provider Identifier) as its unique identifier. While hospitals and other medical organizations will have only one CCN Number, they are required to have at least one NPI number, and they're permitted to have as many as they like (and they do seem to like quite a few). 

And, between these two ID systems, the CCN and the NPI, ne'er the twain shall meet.

CarePrecise has developed a sophisticated system to "roll up" an organization's NPI-numbered records with its CCN number (and with the PAC ID for practice groups, which stands for "PECOS Associate Control ID"). This mighty trick produces some eye-opening data, such as contact names and titles, license information, specializations, market data added by CarePrecise to NPI records, and the ability to crossmatch groups to their members and hospital affiliations, directly from their NPI numbers. It also permits integration across the complete line of CarePrecise provider data packages, and all of the information that CarePrecise collects or creates and then merges to the NPI records.

Currently, these CarePrecise rollups (or "crosswalks" if you prefer) are the only available such thing in a relatively comprehensive dataset. The full rollup of all medical facility NPI numbers is available for hospitals, and a single "priority" NPI number is currently available for practice groups, with a full rollup of all PAC ID-to-NPI linkages in development with a tentative release date in May 2023.

The hospital CCN-to-NPI crosswalk is part of the Authoritative Hospital Database (APD), and the Group PAC ID-to-NPI link is part of the Authoritative Physician Database (APD) and CarePrecise Platinum.

The "rolling up" is made possible by several CarePrecise innovations, starting with the CoLoCode (co-location code) affixed to almost every provider in the 7 million+ record CarePrecise master reference database. To fill in additional linkages, the Placekey is used. Placekey is a unique "point of interest" identifier, also attached to essentially every one of the 7 million+ CarePrecise provider records, which can readily be used to link data between data suppliers for a variety of purposes.

* The CMS Certification Number has replaced the term Medicare Provider Number, Medicare Identification Number or OSCAR Number. The CCN is used to verify Medicare/Medicaid providers for survey and certification, assessment-related activities and communications. Note that CarePrecise includes the old OSCAR Number in its CarePrecise Complete and CarePrecise Advanced/Platinum datasets, if reported by the provider in their NPI record(s) or available through third-parties, but this is a small fraction of records, and the OSCAR numbers have changed, hence the need for a CCN-to-NPI crosswalk.