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.

How to Save Money on Healthcare Provider Data

It might seem like this is a shameless, self-serving promo for CarePrecise provider data packages. Unsurprisingly, our name does come up a lot when companies stagger away in shock from the prices our competitors charge. But that's not what this post is about. We're going to talk about (mostly) free data.

Hopefully this post will help you find provider data that's available for free from the U.S. government. Using free data you can boost the information value in any provider contact list. If you're working with a helpful data vendor, chances are they'll help you find where you can download particular kinds of data you're looking for. For instance, we have a lot of customers who use our basic hospital database who need additional components that we don't package with the product, but we know where to find them and we're glad to share our knowledge. 

Of course, we could pull all of that data into our hospital dataset, but there's SO much out there, and if we did that the product would be very expensive indeed. That database sells for $939 but would be a couple of orders of magnitude pricier with all of just the 70 U.S. hospital data files listed in just one spot on the Centers for Medicare and Medicaid Services (CMS) website.

So, instead of trying to pack everything in, we bring together the hard-to-find/basic-necessity data, and assist customers in finding additional information specific to their particular need. Here are some of our more common recommendations.

When on the hunt for data gold, it can be painfully difficult to locate that needle in the haystack. The screenshot shows the count of the results of a search on the federal data website, data.gov, for "healthcare provider data." 127,500 datasets would be a daunting place to start digging. It's like, "Go get the gold! It's somewhere in that there mountain." Fortunately, we have had some experience with healthcare data excavation, and can often point our customers to pay dirt.

If you have talented data people, a good starting place is the NPPES dataset (National Plan and Provider Enumeration System), which contains about 7.4 million NPI records for individuals and organizations. The download file is much to large to use in ordinary office software, so your team will have to cut it into pieces. Or you can get the full NPPES already processed into a form to be used with Microsoft Office programs from CarePrecise. The CarePrecise product also contains additional data, such as sanctions, and whether or not a practitioner is enrolled to bill Medicare.

Once you have basic data on the providers, you'll want to add linkages between the clinicians and their practice groups and hospital affiliations. You can download the free Physician Compare database and have your tech team work its magic here, too, to make it useable on ordinary office computers. This used to be easier back when CMS included hospital information in the database, but now just to get all the hospital names and basic info you have to ingest ten additional datasets. The list is too big to include here, but highlights include the Licensed and Certified Healthcare Facility Listing where you'll find hospitals' CCN numbers matched to their names and addresses, and Medicare Inpatient Hospitals where you'll find some payment information. You'll want to head on back to CMS to pick up outpatient hospital info. These are just a few of the dozens of datasets we ingest on an ongoing basis to produce our monthly updates. For the datasets we monitor but don't regularly ingest, we're more than happy to help customers dig it up.

Hospital data is a bit easier to find and work with than practitioner data. For instance, the list of U.S. physicians is about 1.1 million doctors long, and that's too big to open in Excel. You'll need to get the physician files into a relational database for them to be very useful. If you're starting from the provider data catalog, you'll see the datasets for hospitals, home health agencies and other kinds of healthcare providers, as well as those doctors and other clinicians. You can also find physicians' CAHPS (patient experience metrics), as well as many of the types of procedures physicians perform.

Perhaps the best advice we find ourselves giving our customers who want to go it alone is to have a crackerjack tech team, or at least one person with a lot of database savvy, and start with buying a basic provider data product that you can use as a data structure template. Most federal data on clinicians is linked to their NPI number, so that's where you'll start building your relational database. Your next step is to talk with whoever sold you your basic data, and ask for help finding any missing components. CarePrecise prides itself on offering most of these, all ready to use, but some customers just enjoy the hunt, and even our most comprehensive data package can't contain everything you might want.

We don't shy away from telling our customers where they can find what they're looking for, even if the only place happens to be one of our competitors. In fact, CarePrecise data is compatible with data structures used across the industry. We even provide the Placekey for almost every record in our products, which connects our data with visitor traffic data and other Point of Interest (POI) products offered by other companies.

Many CarePrecise customers get our extended provider data package. CarePrecise Platinum has those elusive practice group and hospital affiliations, and software that makes it possible to get at exactly what you need without knowing anything about databases. It makes a great starting place for building your own bespoke database. 

About Updates

When you're finding and ingesting data, it's important to plan for updates. Some data sources are updated weekly, others monthly or quarterly, and some only on an annual basis. Create a table listing the resources and their update frequency, and build in the necessary automation to re-ingest them regularly.  This is especially important if your use case requires up-to-date information. This often overlooked step of building-in updates can be costly to do later on. Best if it's baked-in from the beginning. This includes your ingestion process for data you get from us, which you can automate to import the monthly or quarterly updates. We offer FTP delivery as an option, which can put the data directly onto your server, ready to be ingested by stored procedures that are triggered by the upload of the data, or by the modified date on the files.

If you want some help finding data sources, just speak with your CarePrecise representative. We may already have an affordable solution that will save you many hours of understanding an unfamiliar and often cryptic dataset. If we don't have it, your representative will help you find it.

One quick note... We offer these sourcing services to current CarePrecise subscribers. It would be great if we could open it up to everyone, but we have to keep our focus on our customers.

Physician Quality Grading for Consumers

Update March 2023: Physician Compare data is available as part of a rich physician database compiled from Physician Compare and numerous other sources. All reported physician/facility affiliations are included, with more than 50,000 medical facilities covered. 

Columbia University Medical Center has just this week [week of 4/12/2016] published a guide to the Physician Compare quality data. While the release of physician quality data has been delayed, expectations are that it will appear in 2017.

CMS will generate star ratings based on data drawn from the Consumer Assessment of Healthcare Providers and Systems (CAHPS), the Physician Quality Reporting System (PQRS), as well as Accountable Care Organization (ACO) and claims data. CMS will set benchmarks based on the Achievable Benchmark of Care (ABC) methodology.

The data will be made available with the intent to help consumers to make informed decisions and to encourage physicians to improve performance, leading to more efficient and healthful outcomes.

CarePrecise will continue to monitor the project, and will begin including physician quality data in an upcoming product, The Authoritative Physician Database™, as it currently does with its product The Authoritative Hospital database™. CarePrecise is a leading supplier of healthcare provider data used in consumer-facing web and mobile applications, through special licensing arrangements.

COMING: Standard Quality Measures

The Obama administration, acting in concert with the health insurance trade group America's Health Insurance Plans (AHIP), announced today an agreement to develop a standardized set of healthcare quality measures for physicians. In particular, the new quality measurement system will track care given by accountable care organizations, patient-centered medical homes, primary care physicians, cardiologists, gastroenterologists, HIV and hepatitis C care providers, medical oncologists, orthopedists, obstetricians and gynecologists.

As physician's pay from insurance plans is more and more tied to quality outcomes - did the patient get well, or will there be additional claims down the road? - a system for measuring outcomes has become necessary. In recent years, government and private health plans have been working separately, and a confusing array of different measures for different companies has been growing. The CMS/AHIP agreement will seek to create a single standard system of measurement, relieving much of the burden caused by separate systems. In their news release, acting CMS administrator Andy Slavitt stated that "this agreement today will reduce unnecessary burdens for physicians and accelerate the country's movement to better quality." Representatives of the American Medical Association and the Americal Academy of Family Physicians praised the effort.

Out of the Silos: Combined Healthcare Provider Data

You always knew it was possible to get all of the rich federal data on healthcare providers together in one place, and in a form you could use on your PC. And you were simply ecstatic when CMS released the NPPES database! But then you downloaded it and learned that there is simply no normal desktop software that can make that data accessible to you. Rats!

Then CarePrecise created a version of that data -- our flagship product, CarePrecise Access Complete (CPAC), so you could use all 4 million provider records on your computer. Yay! But then you found that it was hard to get around in all that data. Rats! So CarePrecise released the CP ListMaker software that makes getting at the data you want a walk in the park. Excellent! And you wanted some way to know which providers were sanctioned, or that they were eligible to bill Medicare, so CarePrecise integrated data from the PECOS (Medicare) database and the LEIE (List of Excluded Individuals and Entities). Fantastic!

Then you wanted more than the single practice location and fuzzy practice group data that the NPPES gave you, so CarePrecise integrated all of the Physician Compare data with CPAC. Cool! And you wondered how would you ever tame all of that hospital data, so CarePrecise integrated a de-duplicated list of hospitals and the Hospital Compare data, and while we were at it, we included hooks into the hospital quality data and the upcoming physician quality data. And all of it -- the NPPES, PECOS, LEIE, Physician Compare, Hospital Compare (plus some really nice additional stuff like proper-cased name and address fields, provider service area wealth data, and urban/rural/suburban designations) -- all integrated into a single relational database, linked by the NPI number. And you though it couldn't be done.

Now we call that sweet package of data heaven by a weird name: The CarePrecise Total Bundle. And as we integrate upcoming federal data releases, will we be tucking them in there too? You betcha. That's what CarePrecise is all about: healthcare provider data integration and application.

It's brand new and available now: The only 360 degree view of U.S. healthcare provider data. Total Bundle pricing is just $689. That's less than 2/100ths of a penny per record for the most complete physician database / hospital database / dentist database... available anywhere.

You're welcome!