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.

Again: Call for CMS to Release Tax Numbers

It's 2022 and still CMS fails to include healthcare organizations' tax numbers. Whether you call them TIN or EIN the numbers are not sensitive in any way, and the Centers for Medicare and Medicaid Services should release them. This is a repost of an article from 2010, more than 3 years after the first NPI Registry data was made public - except, of course, for those tax numbers:

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The NPI Final Rule called for CMS to establish a system that would assign a National Provider Identifier (NPI) number to essentially every healthcare provider in the U.S. (HIPAA "covered entities"): now more than 3 million providers and growing. Great. But it was years before CMS released that data for the industry to use. CarePrecise personnel were at the forefront even back then, calling for CMS to release the data. If necessary, we were ready to fight for it, filing our own request under the Freedom of Information Act (FOIA). Federal agencies can't keep such kinds of data from the public. It's the law. CMS eventually looked at FOIA, and at their provider data, and decided that, sure enough, they were going to have to release it. We and our clients were ecstatic; now the industry would be able to produce the complex crosswalks necessary to actually achieve the efficiencies promised by the Final Rule.

Hurray... except CMS decided not to release one of the most useful data points of all. A provider's federal tax number is hardly a private number. Businesses have to give their tax number on every imaginable type of transaction. Employees see the employer's number on their W-2s. CMS's excuse was that sole proprietors and pretty much all individual practitioners would have to give their Social Security Number, or that busy doctors might type in the SSN in the wrong spot. Fair enough, but, as everyone who works with data knows, it's a piece of cake to parse a tax number field to determine if the number is a SSN or a business tax number. In fact, that's just exactly what CMS does in the Other ID fields of the NPPES (National Plan and Provider Enumeration System) database, replacing 000-00-0000 with a string of equals signs.

Instead of just redacting the SSNs, CMS decided it was best just to wipe clean the complete Employer Identification Number (EIN) field -- just in case some uppity docs got... uppity. Many of us have been hoping that CMS would revisit the issue of this gaping hole in the provider data, but it seems that the issue is to be ignored so that it will just go away.

So, here we are, once again, years into it, asking CMS to release non-SSN tax numbers/EINs so that we -- health systems and health plans large and small, clearinghouses, HIT vendors, medical billing and coding vendors -- can make this data do what it was intended to do for healthcare and for the taxpayers.

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Check out the NPI information at CarePrecise.

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.

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!

HIPAA-Covered Providers Top 4 million

With the August, 2013 data release, a new milestone has been reached in the U.S. healthcare industry. There are now 4,021,049 healthcare providers covered under HIPAA, of which 900,126 are physicians.

Over 1 million entities, mostly physicians and physician groups, are enrolled to bill Medicare, according to the PECOS Ordering and Referring report.

Added just this month were 30,578 new NPI records. Over the past 60 days, changes were made by healthcare providers on 127,972 NPI records.

The CarePrecise Access Complete dataset includes all of these records.