Provider data update   
May 15, 2013    

CarePrecise Access™ and CarePrecise Select™ Documentation

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

 

CarePrecise Access is the most complete healthcare provider database publicly available, in that it includes all U.S. healthcare providers who are HIPAA covered entities, and it contains not only exhaustive contact information, but up to 68 identifying codes per provider, including the NPI number and other reported codes such as the UPIN, Medicaid number, taxonomy codes, state license numbers, PECOS enrollment status, etc.

Recent additions to the data

  • Deactivated records are now indicated with the precise deactivation date, and are provided in separate tables with their complete data.
  • Using advanced record-linking, CarePrecise now provides a table of co-location codes (the tCoLoCode table), which makes it possible to query providers practicing at the same location. May be used to find providers practicing within, and departments of, organizations; and to identify group practices of any specialty or health provider type, including physicians, dentists, vision care, physical therapists, etc. Exclusive to CarePrecise products
  • New data has been included that identifies providers who have reported as group practices, newly released as part of the NPPES data.
  • Significant improvements in linking LEIE data (providers excluded form billing federal programs as a result of fraud and other issues) with NPPES data, to provide a Warning flag in the NPI database. Provides almost perfect correlation between LEIE and NPPES records. Exclusive to CarePrecise Access products.

 

Data Content & Sources

CarePrecise data packages contain scaled data from federal and other sources, including the National Plan and Provider Enumeration System (NPPES) and the Provider Enrollment, Chain and Ownership System (PECOS), maintained by the Centers for Medicare and Medicaid Services (CMS), a part of the U.S. Department of Health and Human Services (HHS) and fraud warnings provided from the federal List of Excluded Individuals (LEIE) database using an algorithmic record linking system*. No NPPES data field is left out of the CarePrecise Access dataset, but additional data may be added or conformed to improve comprehension or searchability, depending on the specific CarePrecise product; for instance, 2-digit state codes and UPIN numbers are conformed where appropriate. 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 (economic, social) is included in some packages. For more details, review a description of the National Provider Identifier (NPI) and the NPPES database.

All healthcare providers are included. Users can export specific types of provider, e.g., physicians or hospitals, by querying on the specific taxonomy (specialty) code(s).

Co-location codes, which identify providers practicing at the same location, are established by CarePrecise, and are exclusive to CarePrecise products.

 

Data Freshness, Accuracy and Exceptions

CarePrecise Access data is updated every month, usually within a few days of release of the updated source data by federal agencies. And also unlike many in-house systems and other NPI data services, the CarePrecise system generates no exceptions in processing and matching the core provider data. Any exception is corrected through successive processing loops, and our relational table design virtually eliminates query failures. Accuracy is guaranteed; CarePrecise datasets are strictly faithful to the source data. Original content (extrapolated and algorithmically matched data) which are included in CarePrecise Access, including LEIE and EPLS excluded providers/vendors data, which share no common unique identifier with the NPPES data*, is subjected to rigorous record-linkage processing.

 

Deactivated Provider Records

Two new databases have been added to the CarePrecise Access Complete data distribution, NPPES_Deact and NPPES_Delta. The tDeact table lists all NPI numbers that have been deactivated since the beginning of the NPI enumeration system, going back to 2005, showing only the NPI and the date of deactivation. The Delta databases includes complete data on the deactivated provider records, showing all of the data from the CarePrecise Access Complete dataset, going back to January, 2011. Each record in the NPPES_Delta tables reprewsents a provider record that has been deactivated by CMS and no longer appears in the current month's data distribution, but DOES remain in the exclusive CarePrecise delta database, to which are added each month's deactivated records. See the fields list below for descriptions of the delta tables.

 

Added & Dropped Provider Records

These 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 NPPES database upon the monthly updates. The tables grow each month; each record is dated so that it is possible to know when a provider record was added or dropped. The dropped records table includes name and contact information, as well as the NPI number.

 

Group Practice Data

Two separate but complementary data sources now make it possible to identify group practices. The first, group data provided by CMS, identifies providers who have reported a multi-specialty group or single-specialty group practice. We provide both a "Group" flag in the provider's data, and new relational table with the reported codes (tTaxoGroup).

Beginning with the December release (to be distributed in January, 2012), the second tool we provide to identify groups is the new co-location code table (tCoLoCode). The CoLoCode is an algorithmic derivation from provider practice data, which facilitates querying providers by practice location. Our SQUIRRelate™ record linking system standardizes and conforms location data beyond postal specifications to link providers practicing together.

These data can be used together to successfully identify physician groups and all of their specialties, and the CoLoCode data can be used to identify any provider type in a co-located group practice, including dentists, optometrists, radiologists, etc. The CoLoCodes can also be used to identify physicians and others working within large health systems, universities and other institutions.

You can select by size of the practice (number of co-located providers, selecting a range (i.e., between 5 and 50 providers).

Example Application: The co-location codes let you find large (or small) clinics, based on the Count field, which shows the number of providers in the database with the same practice location. For instance, while the code UICFLG70MMPNPNHRR seems meaningless, it happens to be a CoLoCode for the Cleveland Clinic in , and it can instantly filter the database to show you all of the 2700+ providers practicing at the Cleveland Clinic's 9500 Euclid Avenue site.

 

File Formats

CarePrecise Access is available in two file formats, each containing identical data:

  • Microsoft Access 2000/2003/2007/2010 (.mdb); ten normalized relational tables, plus a control database with query examples
  • Comma Separated Values (.csv), supporting FileMaker, MySQL and other database systems, on Windows, Mac or Linux; ten normalized relational tables

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, among other formats. Conversion to MSSQL (is accomplished within SQL Server.

 

Data Structure

CarePrecise Access is distributed as eleven normalized relational database tables, each keyed by the National Provider Identifier (NPI) number, plus a core Microsoft Access database that links the ten tables together and includes query examples, and CSV versions of the normalized data files. Three additional tables are included which contain records that have been dropped, the complete LEIE database, and a table of new healthcare provider records. CarePrecise Gold includes these plus additional tables used for economic and social targeting, and proper casing of names and addresses.

Through data normalization and related techniques, CarePrecise reduces 330+ fields that care compiled from all sources to a much smaller number of 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, even with the additional data fields added from other sources. Across all of the federal data sources, CarePrecise Access represents a deflation of approximately 91%, while preserving the full functionality of the publicly available data. Download a sample CarePrecise Access data pack here; the sample is the same in structure as the full set, but only a small number of records.

 

Data Model

As shown in the illustration below, the eleven primary data tables are linked by the NPI (National Provider Identifier) field. The tables on the bottom row in red contain one record 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.

Click for a printer-friendly version of the fields list.

CarePrecise Data Tables & Fields Use scrollbar at right of box to view all tables and fields ¬
TABLE CarePrecise fieldname Description of field, and/or source fieldname Additional information
tAddresses NPI National Provider Identifier (unique National Provider Identifier assigned to healthcare providers by the US Department of Health and Human Services)

Relational Key

The NPI is a unique 10-digit numerical code assigned to every HIPAA-covered healthcare provider, including individuals and organizations, by the U.S. Department of Human Services, Centers for Medicare and Medicaid Services (CMS).

 

(Provider addresses; MDB and CSV formats) Mail1stAddr Provider First Line Business Mailing Address  
Mail2ndAddr Provider Second Line Business Mailing Address  
MailCity Provider Business Mailing Address City Name
  
MailState Provider Business Mailing Address State Name

The federal data contains variations on state codes, abbreviations and full state names; we conform this field to standard 2-character state codes where possible.

 
MailZip Provider Business Mailing Address Postal Code (most are 9-digit Zip Codes)  
MailCountry Provider Business Mailing Address Country Code (If outside U.S.)  
Prac1stAddr Provider First Line Business Practice Location Address  
Prac2ndAddr Provider Second Line Business Practice Location Address  
PracCity Provider Business Practice Location Address City Name  
PracState Provider Business Practice Location Address State Name

The federal data contains variations on state codes, abbreviations and full state names; we conform this field to standard 2-character state codes where possible.

 
PracZip Provider Business Practice Location Address Postal Code (most are 9-digit Zip Codes)  
PracCountry Provider Business Practice Location Address Country Code (If outside U.S.)

 

  
tEntity NPI National Provider Identifier Relational Key
(Provider entity and record information; MDB and CSV formats) EntityType Entity Type Code

Type 1 indicates an individual provider (i.e., physician, psychologist, etc.); Type 2 indicates an organizational provider (i.e., hospital, lab, pharmacy, etc.)

 
ReplacementNPI Replacement NPI  
EIN Employer Identification Number (EIN) CMS is not yet providing tax numbers of this type
EnumDate Provider Enumeration Date  
UpdateDate Last Update Date Date this provider NPI record was last updated
DeactReason NPI Deactivation Reason Code Not currently populated
DeactDate NPI Deactivation Date Not populated because records in the current dataset are not deactivated. This field IS populated in the separate delta table tEntity_DEACT, described below.
ReactDate NPI Reactivation Date Not currently popluated
Gender Provider Gender Code M or F for Type 1 providers
IsSoleProp Is Sole Proprietor Y indicates provider operates as a sole proprietor business form.
IsOrgSubpart Is Organization Subpart

For Type 2 providers, may be one of several organizational units, each with its own NPI number

 
ParentOrgTIN Parent Organization TIN

CMS is not yet providing tax numbers of this type

 
InPECOS From monthly CMS PECOS distributions of PECOS-enrolled providers. Source: PECOS file distribution, linkage derived algorithmically* beginning with December 2011 release.

Y= provider is enrolled in PECOS (eligible to bill Medicare); N = not enrolled. Uppercase Y indicates exact NPI match in PECOS history; lowercase y indicates algorithmic match without historical verification.

 
Warning

From the Office of Inspector General's excluded providers database (LEIE). A warning in this field should not be taken as definitive; the user should check the tExcluded table and consider other sources of provider fraud and exclusion information. (Algorithmically derived*).

 

Y= elements in the providers record indicated a match with a listing in the federal excluded providers database (see the table tExcluded below)

 

ExclType

The exclusion type from the LEIE database, explaining the reason that a provider was barred from billing Medicare. Fields with a Y in the Warning field will display this code.

 

The code's definition can be found at this link. A CSV file listing these exclusion descriptions is included in the CarePrecise Access Complete CSV download file.

 
UPIN Obsolete physician identifier, still used in some legacy systems. Sources: NPPES and LEIE.

 

 Where available

 
Group From NPPES group taxonomy data.

Y= this provider reported that it operates as either a multi-specialty group or single-specialty group.

 

tHumanNames NPI National Provider Identifier Relational Key
(Provider human names, esp. Type 1 individual providers; MDB and CSV formats) LN Provider Last Name (Legal Name) The enumerated provider's name
FN Provider First Name
MN Provider Middle Name
PN Provider Name Prefix Text
SN Provider Name Suffix Text
Cred Provider Credential Text
OthLN Provider Other Last Name "AKA" name: Nee name, nickname, etc.
OthFN Provider Other First Name
OthMN Provider Other Middle Name
OthPN Provider Other Name Prefix Text
OthSN Provider Other Name Suffix Text
OthCred Provider Other Credential Text
OthLNType Provider Other Last Name Type Code
AuthLN Authorized Official Last Name

Name of the provider's authorizing official, if other than the listed individual provider. For organizations, this is the contact name.

 
AuthFN Authorized Official First Name
AuthMN Authorized Official Middle Name
AuthTitle Authorized Official Title or Position
AuthPN Authorized Official Name Prefix Text
AuthSN Authorized Official Name Suffix Text
AuthCred Authorized Official Credential Text

 
tOID NPI National Provider Identifier Relational Key
(Other identifiers, such as UPIN, OSCAR, PIN, Medicaid, etc., excluding NPI and taxonomy codes; MDB and CSV formats) OtherID Other Provider Identifier_[1 through 50]  
OtherIDType Other Provider Identifier Type Code_ [1 through 50]
Description OtherIDType
Other
1
Medicare UPIN
2
Medicare ID-Type Unspecified
4
Medicaid
5
Medicare OSCAR/CERTIFICATION
6
Medicare NSC
7
Medicare PIN
8
OtherIDState Other Provider Identifier State_ [1 through 50] In the case of a state license code, this is the licensing state
OtherIDIssuer Other Provider Identifier Issuer_ [1 through 50]  
OIDnum Source: Added by CarePrecise to indicate the original NPPES flat file Other Identifiers field number. The number of the NPPES Other Identifier field (1 through 50)

 
tOrgNames NPI National Provider Identifier Relational Key

(Provider organization names, esp. Type 2 providers; MDB and CSV formats)

 

 OrgName_LBN Provider Organization Name (Legal Business Name) LBN
OthOrgName Provider Other Organization Name Other
OthOrgNameType Provider Other Organization Name Type Code  
ParentOrgLBN Parent Organization LBN

 

  
tPhoneFax NPI National Provider Identifier Relational Key

(Provider phone and fax numbers; MDB and CSV formats)

 

 MailPhone Provider Business Mailing Address Telephone Number  
MailFax Provider Business Mailing Address Fax Number  
PracPhone Provider Business Practice Location Address Telephone Number  
PracFax Provider Business Practice Location Address Fax Number  
AuthPhone Authorized Official Telephone Number

 

  
tTaxo NPI National Provider Identifier Relational Key

(Provider Taxonomy codes indicating specialties and subspecialties for Type 1/individual providers, and facility types for Type 2/organization providers; MDB and CSV formats)

 

 Taxo Healthcare Provider Taxonomy Code_[1 through 15]  
Lic Provider License Number_[1 through 15]  
LicState Provider License Number State Code_[1 through 15]  
TaxoSwitch Healthcare Provider Primary Taxonomy Switch_[1 through 15]  
Tnum  

The number of the NPPES taxonomy field (1 through 15)

 
TaxoDescr   Taxonomy code description (the specialty/subspecialty in English)

 
tTaxoGroups NPI National Provider Identifier Relational Key
(Provider Taxonomy codes indicating group practices; MDB and CSV formats) Gnum

The source data (NPPES) permits group codes to be reported in up to 15 fields in this section. CarePrecise creates a 1-to-many table, listing each of a provider's reported txonomy group codes in a separate record. The Gnum is the NPPES Group Taxonomy field number in which the code was reported, allowing the code be matched with the specific group specialty in the tTaxo table. For instance, a code in tTaxoGroup field Gnum 3 indicates a group practice of the specialty reported in Tnum 3 in the tTaxo table.

 

This is the newest of the data released by CMS in the NPPES file. This is where the group taxonomy codes are reported. CMS does not report the codes in the taxonomy section (which appear in our tTaxo table) because they represent an additional layer of information on any one or more of the tTaxo codes.

 

  TaxoGroup Healthcare Provider Taxonomy Group_[1 through 15]

193200000X for a multi-specialty practice
193400000X for a single-specialty practice

 
tCoLoCode NPI National Provider Identifier Relational Key
(MDB and CSV formats) CoLoCode

Provider co-location code (algorithmically derived*). The NPI and CoLoCode comprise the dual relational key for this table. The NPI identifies the provider record, and the CoLoCode identifies the co-located group. The CoLoCode is an up to 40-character string that stands in for detailed location data, and is not intended to be sensical to the human viewer. The CoLoCode /Group Practice system is in beta and subject to change, although code assignment per location is designed to remain static month-to-month (i.e., a given practice group's code would remain the same from month-to-month, while members' codes would change as they move to different practice groups) unless the group's location changes, as the code is predicated on practice location.

 

This code is an algorithmically derived conformation of the provider's practice location, permitting identification of providers who practice at the same location, for instance, physician groups, dental groups, radiology groups, etc. By using this table in conjunction with the tTaxoGroups table, it is possible to visualize the group entity (generally an organization) and its provider members.

Although each provider should have only one primary practice location in our database, technically, the tCoLoCode table is 1-to-many, because our system may not be able to resolve a single practice location per provider. There may be up to two distinct CoLoCodes for some providers.

 
Count

Count of providers matching this co-location (algorithmically derived conformation of the provider's practice location; see tCoLoCodes above). Indicates the number of providers practicing at this co-location.

 

  
tAdded NPI National Provider Identifier Relational Key

(MDB and CSV formats)

DateDiscovered   The CarePrecise processing date on which the added provider record was discovered. Corresponds to the most recent previous CMS update date on which the added provider data was included in the NPPES database.

 
tDropped NPI National Provider Identifier Relational Key

(MDB and CSV formats)

 DateDiscovered  

The CarePrecise processing date on which it was discovered that the provider record was dropped from the NPPES database. Corresponds to the most recent previous CMS update date on which the provider data was dropped from the NPPES database.

 

EntityType Entity Type Code

Type 1 is individual providers (i.e., physicians, psychologists, etc.); Type 2 is organizational providers (i.e., hospitals, labs, etc.)

 

ProvName  

This is a generated field based on EntityType.

 
Prac1stAddr Provider First Line Business Practice Location Address  
Prac2ndAddr Provider Second Line Business Practice Location Address  
PracCity Provider Business Practice Location Address City Name  
PracState Provider Business Practice Location Address State Name

The federal data contains variations on state codes, abbreviations and full state names; we conform this field to standard 2-character state codes. A small number of non-US postal addresses remain nonconforming.

 
PracZip Provider Business Practice Location Address Postal Code  
PracCountry Provider Business Practice Location Address Country Code (If outside U.S.)  
PracPhone Provider Business Practice Location Address Telephone Number  
EnumDate Provider Enumeration Date  
UpdateDate Last Update Date Date this provider NPI record was last updated

 

tExcluded

 LN Last name (Type 1 providers)

This table, sourced from the LEIE, lists all provider records in the federal excluded providers database. A provider may be excluded (barred from billing Medicare) for reasons of a criminal nature, among other reasons. This table contains no relational key; however, it is used to produce the Warning field in the tEntity table, which does include the provider's NPI. This table should be referenced for backup information.

 
(MDB and CSV formats) FN First name (Type 1 providers)
MN Middle Name (Type 1 providers)
OrgName Organization name (Type 2 providers)
Addr Street address
City City
State State
Zip Zip Code
DOB Date of Birth (currently unpopulated)
General Provider category
Specialty Provider specialty
UPIN Federal physician identifier code (legacy)
ExclType Exclusion type (why provider was excluded)
ExclDesc Exclusion Description
ExclDate Date provider was excluded (YYYYMMDD)

 
tDeact NPI National Provider Identifier

This table is provided by CMS, listing all NPI records that have been deactivated and the deactivation date.

 
(MDB and CSV formats; CarePrecise Access Complete and CarePrecise Gold only) DeactDate Date CMS deactivated the provider's NPI record
DeactFound Date deactivation was processed by CarePrecise

Delta tables in NPPES_Delta.mdb

(MDB format; CarePrecise Access Complete and CarePrecise Gold only)

tAddresses_DEACT
tEntity_DEACT
tHumanNames_DEACT
tOID_DEACT
tOrgNames_DEACT
tPhoneFax_DEACT
tTaxo_DEACT
tTaxoGroups_DEACT
tCoLoCode_DEACT

 The Delta tables are contained in a separate database included in the CarePrecise Access Complete dataset, named NPPES_Delta. They contain the complete data on providers whose records have been deactivated by CMS for various reasons, including retirement, death, or for any of several infractions. These tables contain the same fields as the standard provider data tables as defined above for their namesakes, and are populated with the data from previous data releases, with the deactivation date populated in the tEntity_DEACT table's DeactDate field.
Additional data included only in CarePrecise Gold (from USPS, U.S. Department of Commerce, and independent CarePrecise research):
tZips
Economic and social segmentation data for providers' service areas
(This table is included only in CarePrecise Gold; MDB format)		 ZipCode 5-digit Zip Code  
Wealth Numerical indicator of the relative wealth/poverty of the provider's immediate service area (zip). Wealth/poverty level is show as a percentage of the Federal Poverty Level (FPL) for the particular geographic area. Currently up to 12 levels are present in the data; additional levels will be included when data for those more extreme wealth levels are present.
Description Wealth Level
=<50% FPL 1
50% to 100% FPL 2
100% to 150% FPL 3
150% to 200% FPL 4
200% to 300% FPL 5
300% to 500% FPL 6
500% to 700% FPL 7
700% to 1000% FPL 8
1000% to 1500% FPL 9
1500% to 2000% FPL 10
2000% to 3000% FPL 11
Greater than 3000% FPL 12

 
RuralUrban Indicates Rural (R), Urban (U) or Other (O) status for the provider's immediate service area (zip). Other indicates suburban or small city status.  
City City associated with Zip Code  
County County primarily associated with Zip Code  
State State associated with Zip Code

 

  

Additional data tables:

  • Names
  • Names_Company
  • Names_Cred
  • Names_Genderize
  • Names_Prefices
  • Names_Suffices
  • StateNameVariants

(These tables are included only in CarePrecise Gold; MDB format)

Additional data tables included in CarePrecise Gold are used by the included SharpMail™ tool to produce correctly cased names and addresses and correctly genderized and prefixed salutations.

* Algorithmically derived data in the CPAC dataset includes data that is extracted/mined from the source databases, but which has a margin of error and should not be relied upon as conclusive. Record linking algorithms are used to enrich our data when direct correlation (via a unique identifier field) is not available, using available information in name, address, phone, taxonomy, and other fields. In particular, the data on providers excluded from billing Medicare (from the HHS Office of Inspector General's excluded providers database) can only be linked to NPI records by this means. Please note that when matches are found, there may be instances where an individual or firm has the same or similar name and location information as an excluded provider but is actually a different party. Therefore, it is important that you verify a potential match with the debarring agency identified in the record information. In like manner, the available federal data does not provide information on an individual provider's practice group(s); using record-linkage technology, we extract the group information by matching providers sharing the same practice location, and these group data can be corroborated or enriched with the group practice codes provided by CMS.

 

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/In-House Data

CarePrecise data includes many "hooks" that can be used to key legacy provider databases to the NPI. NPI numbers, telephone and fax numbers and UPINs 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 on nearly every address, and more than 700,000 physician UPINs, as well as complete name data with expanded AKA names, and complete practice and mailing addresses.

NOTE: CarePrecise offers record-linking services that can link our dataset's records to your in-house database in order to, for instance, append updated address, phone and fax information, specialties, group practice information, NPI and license numbers and much more, to your own data, even when no unique identifiers are present in both sets of data for direct correlation. Contact us for details and pricing. Read about our SQUIRRelate™ record linking technology for master data management.

 

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.

NOTE: If you need a completely user-friendly, easy to use pre-built Access application for preparing and exporting lists without database skills, see CarePrecise Gold.

 

Understanding Enumeration

Healthcare providers are required to enumerate in the NPPES database if they are a HIPAA covered entity (that's a much abbreviated statement; see the official CMS documentation for more detail), and must enroll in the PECOS database to be eligible to bill Medicare. Under the NPI rules 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, or facilities, 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

Don't have Microsoft Access, but want to use the CarePrecise database anyway? No problem. You can either import the data into your own system, or get an Access alternative. OpenOffice Base is free, is compatible with our files to allow you to do nearly any kind of lookup, and is available for Windows, Linux and Mac (Linux and Mac versions require you to import our data rather than use the files directly). Ability Pro is another compatibe database product offering more robust features, and is priced under $50. If you want an environment that works on Mac, Linux and Windows, get Kexi, another free solution (Kexi has its own file format, so you'll import our data into it, rather than using our files directly).

NOTE: If you need a completely user-friendly, easy to use pre-built Access-based application for preparing and exporting lists without database skills, see CarePrecise Gold.

 

Licensing

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

 

Other Services

If you are having difficulty exporting or converting the data to a particular form required by your application, please contact us at (877) 782-2294 for assistance with extended data services.

 

System Requirements

For use as CSV data files, database software that can open comma delimited files is required. For operation as a single joined dataset running in Microsoft Access, Microsoft Access 2003 or later is required. You should have 2 gigabytes of RAM (4GB recommended). Approximately 2GB of disk space shouild be allooted 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. The CSV files may be imported into any application that supports comma separated value files and supports approximately 3.9 million rows of data (more for the Taxonomy and Other ID tables).

 

Technical 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.

 

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.

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

Product Evaluation Sheet may be downloaded here.

Sample data may be downloaded here.

Read about our record linkage technology for combining data from multiple sources.

Go here for information about the NPI (National Provider Identifier) number.

 

Query Running Speed

Because CarePrecise datasets are very large (CarePrecise Access Complete contains more than 3.9 million NPI records normalized into ten tables, comprising about 1 billion data points), some complex queries can take a long time to run. If you are unaccustomed to working with very large data files, this may take some getting used to. But you can do some things to dramatically improve running speed. Here are some tips:

  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. Pause or Disable Carbonite Backup. Carbonite and other background backup programs can cause errors and slow-downs when running Microsoft Access processes. Pause or disable these processes while running queries on large datasets.
  5. 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.
  6. Make sure you have adequate contiguous disk space available. As time passes, 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. We recommend periodic defragmentation of the disk which hosts your CarePrecise data if you are frequently using Microsoft Access "Make Table" or "Append" operations. We also recommend defragmenting after a monthly update of the CarePrecise Access Complete dataset, due to the large disk areas that are overwritten.
  7. Don't use CP ListMaker over a network. Use of CarePrecise data products over a high-traffic network will not only slow down the program, but can cause network issues for other users. CP ListMaker is licensed only for use on a single computer (standard license).
  8. Periodically "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 do not, and generally will not need it unless you make changes to the data. 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 primary CarePrecise data files.
  9. 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.
  10. Avoid using the "Like" operator in your queries. The Like operator requires deep parsing and slows down query processing.
  11. Optimize your queries. Review how you can optimize Access query operation; see the following links:

 

NOTICE: The data contained in CarePrecise products is compiled and processed on an ongoing basis, with monthly update releases, from free and fee-based sources, including the National Plan & Provider Enumeration System (NPPES), Medicare Provider Enrollment, Chain, and Ownership System (PECOS), List of Excluded Individuals/Entities (LEIE) 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 investors, partners and affiliates are responsible for data maintained by these or other source providers. All HIPAA covered entity healthcare providers in the U.S. are required under the NPI Final Rule to provide their information to a federal database of healthcare providers 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 as necessitated by source data, beyond the diligent effort to include all released data. To determine a provider's eligibility to practice and/or to bill Medicare, users should not rely solely on data included in the CarePrecise dataset, particularly regarding alleged criminal and/or fraudulent activity given as reason for listing in data on excluded providers. Data which has been in-matched using algorithmic rather than direct means may include a percentage of error; affected data is labled as such in the documentation. Subscriptions are fullfilled with quartery or monthly issues containing the most recently released data from all pertinent sources. CarePrecise, CarePrecise Access, CarePrecise Select, CarePrecise Gold, CP ListMaker and SharpMail are trademarks of CarePrecise Technology. Other trademarks are the property of their respective owners.
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