Provider Data Sources Reference

Last week (May 3, 2024) CarePrecise published a dynamic new healthcare data resource, entitled the Provider Data Sources Reference Guide (or just "PDS" for short). By "dynamic" we mean that it will be continually updated, and it will grow with new entries relating to free and fee-based provider data sources.

Navigating public and private data sources is challenging and time consuming, and it's something that the CarePrecise resources team has been doing for decades. Opening our expertise to the public is built into the DNA of our company. We take pride in being the most open and transparent healthcare provider data vendor, and the Provider Data Sources Reference Guide is just the logical next step.

The PDS is free and publicly available, with listings of data sources, both public and proprietary. It's a great place to find clues about the data sources needed across the healthcare industry. Included are sources that we use to build our authoritative provider data packages, as well as others that can be integrated with data packages from CarePrecise and other vendors using the NPI, CCN and PAC ID unique identifiers, to augment and enhance value for our customers, the industry at large.

Our resources team accepts submissions for entries in the PDS, which are reviewed for quality, pertinence, and value of content. Direct links to the sources are included on the page, where possible.

Using the on-screen tools, listings can be sorted and filtered by Category (such as Physicians, Hospital/Medical Facility, Mental Health, etc.), and by Free, Fee-based, or Limited use sources.

The PDS is a companion to the CarePrecise U.S. Healthcare Administration and Information (USHAI) resources guide, which contains links to medical associations, healthcare IT, cost reduction, patient guidance information, and much more. Both public and proprietary sources are included, and the USHAI guide also accepts submissions from the industry. Note that submissions must come from the source of the information; submissions that come from a public relations agency or other third party are not considered for publication. Both the USHAI and the PDS consider limited commercial content of high quality, with inclusion at the discretion of CarePrecise.

Go here to submit a provider data source for the PDS reference guide. Go here for commercial submissions to the companion USHAI guide.

How to Use Physician Compare to Extract Free Physician Information

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.