CarePrecise Access Documentation

This page contains documentation for CarePrecise Access and CarePrecise Select datasets. For specific instructions on using the CP ListMaker add-on, go here.

DATA CONTENT: CarePrecise data packages contain scaled data from the National Plan and Provider Enumeration System (NPPES) maintained by the Centers for Medicare and Medicaid Services (CMS), a part of the U.S. Department of Health and Human Services (HHS). No NPPES data field is left out of the CarePrecise Access dataset, but additional data may be added, depending on the specific CarePrecise product. PECOS status (whether or not a provider is enrolled to be able to bill Medicare) is included. Taxonomy descriptions (plain English translations of specialty and subspecialty codes) are included in all packages. Market demographic data may be included in some packages.

ADDED & DROPPED PROVIDER RECORDS: Two additional data tables are generated by CarePrecise and included in the CarePrecise Access Complete dataset, representing provider records that have been added to or dropped from the database. The tables grow each month; each record is dated so that it is possible to know when a provider record was added or dropped. Once per year (with the July release), all records aged 4 months and older are dropped from the Added and Dropped tables.

SUPPORT: Different CarePrecise product packages come with different levels and periods of technical support. Refer to the support page for details. Paid extended technical support packages are also available.

FILE FORMATS: Each CarePrecise data product is delivered in two file formats, each containing identical data:

• Microsoft Access 2003/2007 (.mdb); seven normalized relational tables, plus a control database with query examples
• Comma Separated Valued (.csv); seven normalized relational tables

SYSTEM REQUIREMENTS: For operation as a single joined dataset running in Microsoft Access, Microsoft Access 2003 or 2007 is required. You should have 2 gigabytes of RAM (4GB recommended). Approximately 1GB of disk space is required for storage of the MDB files, plus additional disk space when manipulating the data. Because the files are quite large, we recommend disk defragmentation prior to copying the files to your computer for best performance, and periodic defragmentation thereafter if you are frequently using the Access Make Table or Append operations. The CSV files may be imported into any application that supports comma separated value files and supports approximately 3 million rows of data (more for taxonomy and other ID tables).

DATA STRUCTURE: CarePrecise is distributed as seven normalized relational database tables, each keyed by the National Provider Identifier (NPI) number, plus a core Microsoft Access database that links the seven files together and includes query examples, and CSV versions of the normalized datafiles. Through data normalization, CarePrecise reduces the highly redundant 314-field NPPES flat file structure to 65 unique fields, removing large volumes of unused space while preserving every character of the data and all of the original granularity. The data is in no other way "compressed," but is ready to access at as little as 13% of the original file size (varies), and in a form that can readily be searched, manipulated and imported into applications. Download a sample data pack here; the sample is identical in structure to the full set, but a reduced number of records.

DATA MODEL: As shown in the above illustration, the seven data tables are linked by the NPI (National Provider Identifier) field. The tables on the bottom row colored in red are essentially flat files, containing one record, and one record only, for each NPI. (Note that providers may have more than one NPI. See the note below on Understanding Enumeration.)

The tables shown in blue are One-to-Many tables, using the NPI to key up to 15 taxonomy (specialty) codes, and up to 50 Other Identifiers (UPIN, Medicare PIN, etc.). Thus, one NPI may be repeated many times in each of those tables, each associated with a different taxonomy or other ID.

For a complete listing of all the field code values used in the NPPES and CarePrecise datasets, download this document.

QUERIES: Query examples are included in the NPPES_Core.mdb database application included with the CarePrecise package. Queries are performed within this application using the extensive and user-friendly tools provided by Microsoft Access. Refer to the examples, opening them in design view, for a detailed understanding of how the CarePrecise data is queried. The CarePrecise data structure make many NPPES queries possible that simply cannot be done on ordinary desktop and laptop computers with other NPPES products.

KEYING TO LEGACY DATA: CarePrecise data includes many "hooks" that can be used to key legacy provider databases to the NPI. NPI numbers, telephone and fax numbers are among the best general unique identifiers for matching to legacy data. Providers have a strong incentive to report all "Other Identifiers" that apply to them, as these are used by insurance payers in claims crosswalks that expedite reimbursement, and even increase reimbursement when preferred credentials and specialties are able to be linked to the claim, through such identifiers as UPIN, Medicare PIN, and others. Hooks for linking legacy data to CarePrecise include 10-digit telephone numbers for more than 99.8% of providers, 9-digit zip codes, as well as complete name data with expanded AKA names, and complete practice and mailing addresses.

REPORTS: Use the NPPES_Core.mdb database application included with the CarePrecise package to create reports using the extensive report creation capabilities of Microsoft Access. NPPES_Core contains sample queries that can be used to pull targeted data.

UNDERSTANDING ENUMERATION: Healthcare providers are required to enumerate in the NPPES database if they are a HIPAA covered entity, and if they appear on electronic claims (that's a much abbreviated statement; see the official CMS documentation for more detail). Under the rule there are two types of providers, Type 1 and Type 2. Essentially, Type 1 providers are individual persons providing healthcare, such as physicians, nurses and psychologists among others, while Type 2 providers are essentially organizations, such as hospitals, labs and pharmacies among others. We say that Type 1 providers are a "face" and Type 2 providers are a "place."

Type 1 providers may have only one NPI number for themselves. But they may have an additional NPI for their corporation. Type 2 providers may have as many NPI numbers as they wish, and typically have multiple NPIs to distinguish business units, and/or to assist with reimbursement pay flow.

MICROSOFT ACCESS ALTERNATIVES: The CarePrecise MDB datasets are offered as a processed dataset, rather than as a software application. The MDB files need a database management system (DBMS), such as Microsoft Access 2000/2003/2007. If you do not have Microsoft Access on your computer, explore available alternatives.

LICENSING: CarePrecise data is licensed for use by the purchaser, including limited redistribution in other than complete form. Review the License Agreement here.

DATA FORMATS: You can use built-in utilities in the MDB application to export the data in most common data formats, including CSV, TXT, MDB, MDE, and DBX. Application extensions are available for conversion to MySQL and MSSQL formats, among others.

OTHER SERVICES: If you are having difficulty exporting or converting the data to a particular form required by your application, please contact us at (918) 406-3998 for assistance with extended data services.

TECHNICAL SUPPORT: Go here to review technical support options.

ADDITIONAL RESOURCES:
Refer to the CMS field descriptions for technical descriptions of the data fields. CarePrecise uses abbreviated field names; see the Data Structure table above for NPPES-to-CarePrecise field name comparisons.

Refer to the CMS field codes document for details on field codes used in CarePrecise.

Refer to the License Agreement for information on permissible uses of CarePrecise data.

Product Evaluation Sheet may be downloaded here.

Sample data may be downloaded here.

Improving Query Running Speed

Because CarePrecise datasets are very large (CarePrecise Access Complete contains more than 3 million NPI records normalized into seven tables, comprising about 1 billion data points), many queries take a long time to run. Here are some tips to improve speed.

1. Close other programs on your computer. Consider not running complex Access queries on the complete CarePrecise dataset while other processor-hungry programs are operating, whether you are actively using them or not. In particular, Microsoft Outlook can cause a serious reduction in processing speed.
2. Make sure you have adequate virtual memory configured. Consult your Windows documentation for instructions on setting virtual memory (search Windows Help for "virtual memory"). We use the following settings for virtual memory: Initial 2046 MB; Maximum 4092 MB; other settings at default.
3. Disable unnecessary Windows Services. Refer to the documentation for your version of Windows to locate the Services window. In particular, the Windows Index service used by the desktop search tool can dramatically affect processing speed. Same goes for third party indexing tools such as the Google Desktop Search tool.
4. Don't allow your antivirus program to run a system scan while you are using the database. Likewise, disable any background tools that hog system resources, such as scheduled backups. It's best to schedule such operations to run at times when you will not be using the computer anyway, but, surprisingly, the default settings of some programs will attempt to run any time your keyboard and mouse are idle, even if the processor is busy trying to do database work.
5. Make sure you have adequate contiguous disk space available. As time goes on, your computer's hard disk becomes fragmented -- especially when you use very large databases like those from CarePrecise. Unless there are large areas of free space on your hard drive for CP ListMaker to use, it can take much longer for processes to run, or processes may fail to complete. Periodically defragment the hard drive on which your CarePrecise products are installed.
6. Don't attempt to use CP ListMaker over a network. Use of CarePrecise data products over a network will not only slow down the program, but may cause network traffic issues.
7. Peridically "Compact and Repair." As you use a Microsoft Access database it can become bloated with unnecessary page fragments. Refer to the help file for your version of Access to learn how to Compact and Repair your databases. The NPPES_Core.mdb automatically Compacts/Repairs itself when you close it. However, the linked NPPES databases are not. To Compact/Repair the linked NPPES databases, open NPPES_Core.mdb, open the System Utilities form, then click the "Compact/Repair All Databases" button. This will run a safe Compact and Repair on your CarePrecise data files.
8. Configure your hard drives/arrays for optimum speed. Consult your system administrator to see if placing CarePrecise on a different hard drive from Microsoft Access will improve data processing speed. Some disk configurations can "double dip" (let parts of programs access two drives simultaneously), improving data access operations.
9. Avoid using the "Like" operator in your queries. The Like operator requires deeper parsing and slows down query processing.
10. Optimize your queries. Iit's a good idea to review how you can optimize Access query operation. See the following links:
    • Allen Browne on Access Optimization
    • Microsoft on Access Query Optimization

NOTICE: The data contained in CarePrecise Access is sourced from the National Plan & Provider Enumeration System (NPPES), Medicare Provider Enrollment, Chain, and Ownership System (PECOS), and other US federal sources obtainable under the Freedom of Information Act (FOIA) and provided monthly by the Centers for Medicare and Medicaid Services (CMS) and Office of Inspector General, divisions of the US Department of Health and Human Services (HHS), and from the US Census Bureau, a division of the US Department of Commerce, agencies of the US federal government, and the United States Postal Service (USPS). Neither CarePrecise nor its partners or affiliates are responsible for data maintained by these or other source providers. The database is the most complete available; all HIPAA covered entity healthcare providers in the U.S. are required under the NPI Final Rule to provide their information to these databases and to update when their information changes. No warranty is expressed or implied as to the accuracy, completeness or timeliness of the information presented here, nor that the data structure will not be changed in the future by CMS, beyond the diligent effort to include all released data. CarePrecise and CP ListMaker are trademarks of CarePrecise Technology. Other trademarks are the property of their respective owners.