CarePrecise® Data Documentation

This page contains data documentation for tables and fields of the major CarePrecise datasets.

Data fully updated as of June 21, 2022

Product description pages:

Provider Email Addresses
CarePrecise Complete dataset
CarePrecise Advanced dataset
CarePrecise Gold package
CarePrecise Platinum package
CP ListMaker software
Authoritative Hospital Databse (AHD)
Authoritative Physician Database (APD)
Physician Performance Module
The Collection: All of the above
ScriptFax: Enhanced Clinician/Prescriber Database
ScribeFax: Enhanced Pharmacy database
Basic Fax Lists

Data documentation on this page:

• Data Structure
• Table and Field List
• Data Freshness, Accuracy
• File Formats
• Data Content & Sources
• Sample Data
• System Requirements
• Technical Support
• Trusted Locations in Microsoft Access®

For instructions on how to use the relational database, click here.

Description of the Data

The CarePrecise data universe is a modular family of datasets, together representing a single relational database spanning a broad healthcare provider information space. The color squares below indicate which module the data belongs to. Refer to the color coding in the Fields List below to view field descriptions for each module.

We provide both Microsoft Access MDB files and standard comma delimited files (CSV) for all provider data tables.

CarePrecise Complete™ healthcare provider data

CarePrecise Complete contains the basic information on the complete universe of the 7.1 million U.S. HIPAA-covered healthcare providers. The field list below includes descriptions of data available in the CarePrecise Complete dataset (color-coded by a gray background). CarePrecise Complete, like all CarePrecise data products, is a relational database, generally using the NPI number as the key across all tables.

Historical Data Included. Historical data including information on deactivated providers. Additional historical data is also available. See this link.

Recently added tables:

• OtherPracticeLocations
• OtherOrgNames

Review their contents below in the fields list.

Click here to view the CarePrecise Complete product page...

Download Data Definitions (CSV)...

Download Data Definitions (Excel)...

CarePrecise Advanced™: The CarePrecise Complete dataset plus the Extended Professional, Group and Hospital (EPGH) module

Adds significant details to CarePrecise Complete for a subset of providers; specifically, those providers who are actively seeing patients and who appear on Medicare claims. The field list below includes descriptions of data available in bundle products that include the Extended Physician, Group and Hospital (EPGH) module, indicated by the blue background.

The extended dataset offers additional information on the nation's active PECOS-enrolled providers, and includes a deduplicated database of approximately 6,000 hospitals, 180,000 practice groups, and 900,000 individual providers (primarily physicians) -- all linked together to provide a 360-degree view of the active provider universe. Physician records are linked to their practice group records, and to their affiliated hospital records.

The EPGH data makes it possible to pull a simple list of hospitals and their affiliated physicians or practice groups, or to pull a list of practice groups and view a verified list of medical professionals affiliated with the groups.

Included with the EPGH module are group practice details, medical school, graduation year, and more.

The extended hospital data includes the Medicare CCN number used to link to other data resources, such as hospital quality data found in the Authoritative Hospital Database.

The EPGH module is not sold separately as a standalone database, but as part of the Master Bundle. It is also included in the CarePrecise Platinum package.

Click here to view the EPGH product page...

Download Data Definitions (CSV)...

Download Data Definitions (Excel)...

ProCase™ properly-cased data

The ProCase module offers the same individual name data, organization name data and address data found in the other datasets, but in properly-cased form. Using a proprietary algorithm based on millions of names and addresses, ProCase provides properly-cased provider names and addresses. ProCase data tables are shown below with a pink background.

The ProCase module is available as an add-on to CarePrecise Complete, CarePrecise Advanced, Platinum, and Gold packages, and is available separately. To order the ProCase add-on to our other products, please contact CarePrecise Sales or call (877) 782-2294.

Click here to view the ProCase product page...

Download Data Definitions (CSV)...

Download Data Definitions (Excel)...

The Authoritative Physician Database™

The Authoritative Physician Database (APD) contains detailed data on all U.S. HIPAA-covered physicians. Although the APD is available separately as a standalone file, it may also be linked with data in other CarePrecise datasets using the NPI, PACID, and CCN fields. The data table shown below with a purple background represents data included in the Authoritative Hospital Database.

Click here to view the APD product page...

See product page or purple highlighted section in table below for data definitions.

The Authoritative Hospital Database™

The Authoritative Hospital Database (AHD) contains deeper data on the widest set of U.S. hospitals. Although the AHD is available separately as a standalone file, it may also be linked with data in the CarePrecise Advanced database using the NPI and CCN fields. The data table shown below with a green background represents data included in the Authoritative Hospital Database.

Click here to view the AHD product page...

See product page or green highlighted section in table below for data definitions.

Additional data contained in Gold and Platinum packages

Data tables shown below with a gold background represent additional data included in the CP ListMaker software bundled with CarePrecise Gold and CarePrecise Platinum. This data is made available primarily for operation of the CP ListMaker software, and may also be used on its own. This data includes geocoding (latitude and longitude), wealth of the provider's service area, urban or rural status, and more.

Click here to view the CarePrecise Gold product page...

Click here to view the CarePrecise Platinum product page...

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Data Structure

CarePrecise datasets are distributed as normalized relational database tables, keyed by the National Provider Identifier (NPI) number, plus a core Microsoft Access database that links the tables together and includes query examples, and CSV versions of the normalized data files. Additional tables are included which contain records that have been newly added, newly dropped, the complete excluded providers database, and tables defining codes used in the database.

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CarePrecise Complete (CPAC) data is sourced and merged from the NPPES, PECOS and LEIE databases, keyed on the NPI. Every record has a unique NPI, and the NPI is used to link the relational tables together. The CPAC dataset is updated monthly. CPAC tAddresses (Provider addresses; MDB and CSV formats) 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). 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 Code   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 Code   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.)   CPAC tOtherPracticeLocations Additional (secondary) practice locations for Type 2 providers; MDB and CSV formats One-to-many table. Table is not provided in custom data pulls (CarePrecise Select services). NPI National Provider Identifier Relational Key (composite) SecondaryPracAddr1 First line of street address Relational Key (composite) SecondaryPracAddr2 Second line of street address   SecondaryPracCity City Name   SecondaryPracState State Code   SecondaryPracZip Postal Code (most are 9-digit Zip Codes)   SecondaryPracCountry Country Code (If outside U.S.)   SecondaryPracPhone Location Phone Number   SecondaryPracPhoneExt Location Phone Extension   SecondaryPracFax Location Fax Number   SecondaryLocationDate Location Date   CPAC tEntity (Provider entity and record information; MDB and CSV formats) CHANGE NOTE: Beginning with the July 2022 release, the fields marked with a † symbol will be moved to a new table named tEntity-C, with the NPI as relational key, to accommodate the growing dataset. NPI National Provider Identifier Relational Key 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.). Type1 entities (individuals) may have only one NPI number and so only one record, but Type 2 entities (organizations) may have multiple NPI numbers and thus multiple records. Click here to download the Exclusion Type Code description document...   ReplacementNPI Replacement NPI Not currently populated EIN Employer Identification Number (EIN) Not currently populated. CMS is not currently providing tax numbers. EnumDate Provider Enumeration Date Date the record was first added to the NPI registry UpdateDate Last Update Date Date this provider NPI record was last updated DeactReason NPI Deactivation Reason Code Not populated because records in the current dataset are not deactivated. Not currently disclosed by CMS. DeactDate NPI Deactivation Date Not populated because records in this table are not deactivated. This field IS populated in the separate delta table tEntity_DEACT, described below. ReactDate NPI Reactivation Date Date record was reactivated following a deactivation. Gender Provider Gender Code M or F for Type 1 providers IsSoleProp Is Sole Proprietor Y = provider operates as a sole proprietor. No = not a sole proprietorship. X = question not answered by provider. IsOrgSubpart Is Organization Subpart For Type 2 providers, may be one of several organizational units, each with its own NPI number. Y = provider is a subpart. No = not a subpart. X = question not answered.   ParentOrgTIN Parent Organization TIN Not currently populated. CMS is not currently providing tax numbers.   InPECOS From monthly CMS PECOS distributions of PECOS-enrolled providers. Source: PECOS Ordering and Referring Report file distribution. Y = Physicians and non-physician practitioners who are of a type/specialty that is legally eligible to order and refer in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in PECOS)   Warning From the Office of Inspector General's excluded providers database (LEIE), indicatying a sanction prevents the provider from billing Medicare. 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. Up until the May 2017 release, this field was algorithmically derived for some records.*   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.   ExclDate The date of the exclusion from the LEIE database, where reported.     UPIN UPIN is a deprecated identifier, no longer used. CMS has stopped disseminating this data. The field remains here for purposes of backward-compatibility.     Group From NPPES group taxonomy data Y= this provider reported that it operates as either a multi-specialty group or single-specialty group.   County   Name of county primarily associated with the practice Zip Code CountyFIPS †   Practice county FIPS code StateFIPS †   Practice state FIPS code TimeZone †   Practice time zone DLSTime †   Daylight saving time; Y= Yes MSA † Metropolitan Statistical Area of practice location Beginning with the April 20, 2020 release, this field will draw on data representing the new 5-digit format for the MSA, also known as the CBSA. The field name will remain MSA PMSA † Primary Metropolitan Statistical Area of practice location   Population †   Zip Code population Zip5   First five digits of practice address Zip Code CPAC tEntity-B (Provider entity and record information; MDB and CSV formats) NPI National Provider Identifier Relational Key CertDate Date of certification of provider's NPI number New field added with December 9, 2019 data release, refers to the date the NPI record was officially certified. EstPracYears Estimated years provider has been in practice Algorithmically derived* from EPGH tExtendedPhysician.GradYear and/or CPAC tEntity.EnumDate 2009 forward. Placekey New with the July 2022 release: Placekey is a universal standard identifier for the physical practice location. Visit Placekey.io for details. Beginning with the July 2022 release: Placekey is a universal standard identifier for any physical place, so that the data pertaining to those places to facilitate sharing across organizations and separate data silos. Placekey provides geospatial data gathered from different sources. CarePrecise is a contributor. CPAC tHumanNames (Provider person names or contact person names; MDB and CSV formats) NPI National Provider Identifier Relational Key LN Provider Last Name (Legal Name) The enumerated individual provider's name (for Entity Type 1 records) 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 Other name Type Codes: Code Description EntityType 1 Former Name 1 2 Professional Name 1 5 Other 1, 2 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 (Contact person for a Type 2 organization record) Name of the provider's authorizing official, if other than the listed individual provider. For organizations (Entity Type 2 records), 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   CPAC tOID (Other identifiers, such as UPIN, OSCAR, PIN, Medicaid, etc., excluding NPI and taxonomy codes; MDB and CSV formats) One-to-many table. NPI National Provider Identifier Relational Key OtherID Other Provider Identifier Identifier relevant to external data OtherIDType Other Provider Identifier Type Code Description OtherIDType Other 01 Medicaid 05 OtherIDState Other Provider Identifier State In the case of a state license code, this is the licensing state OtherIDIssuer Other Provider Identifier Issuer   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)   CPAC tOrgNames (Provider organization names for Type 2 providers; MDB and CSV formats)   NPI National Provider Identifier Relational Key OrgName_LBN Provider Organization Name (Legal Business Name) LBN (for Entity Type 2 records) OthOrgName Provider Other Organization Name Other OthOrgNameType Provider Other Organization Name Type Code Code Description EntityType 3 DBA 2 4 Former LBN 2 5 Other 1, 2 ParentOrgLBN Parent Organization LBN   CPAC tOtherOrgNames Alternative org names beyond those lited in tOrgNames; MDB and CSV formats. One-to-many table. Table is not provided in custom data pulls (CarePrecise Select services). NPI National Provider Identifier Relational Key (composite) OtherOrgName Other Organization Aame Relational Key (composite) OtherOrgNameType Other Organization Name Type Relational Key (composite) Code Description EntityType 3 DBA 2 4 Former LBN 2 5 Other 1, 2 CPAC tPhoneFax (Provider phone and fax numbers; fax numbers for approx. 65% of records; MDB and CSV formats)   NPI National Provider Identifier Relational Key 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     CPAC tTaxo (Provider Taxonomy codes indicating specialties and subspecialties for Type 1/individual providers, and facility types for Type 2/organization providers; MDB and CSV formats). One-to-many table.   NPI National Provider Identifier Relational Key Taxo Healthcare Provider Taxonomy Code (Specialties and Facilty Types) Providers may have multiple taxonomies reported here, and thus multiple records in this one-to-many table. The Taxonomy Code indicates the provider's specialty; i.e., Pediatrician, Optometrist, etc.; or facility type; i.e., Hospital, Clinic, Nursing Facility, etc. Lic Provider License Number For Type 2 (organization) providers, License is no longer collected as of 9/10/2018. LicState Provider License Number State Code For Type 2 (organization) providers, License is no longer collected as of 9/10/2018. TaxoSwitch Healthcare Provider Primary Taxonomy Switch (Primary specialty indicator) "Y" means this is the provider's primary specialty or facility code. Tnum Source: Added by CarePrecise to indicate the original NPPES flat file Taxonomy Code (specialty) field number. The number of the NPPES taxonomy field (1 through 15). If a primary taxonomy is not indicated, it may be useful to assume that the first-listed code (1) is primary.   TaxoDescr   Taxonomy code description (the specialty/subspecialty in English)   CPAC tTaxoGroups (Provider Taxonomy codes indicating group practices; MDB and CSV formats). One-to-many table. NPI National Provider Identifier Relational Key Gnum The source data (NPPES) permits group codes to be reported in up to 15 fields in this section. CarePrecise creates a one-to-many table, listing each of a provider's reported taxonomy 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.   CMS does not report the group 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   CPAC tCoLoCode (MDB and CSV formats) NPI National Provider Identifier Relational Key (composite) CoLoCode™ Provider CoLoCode™ (co-location code, a CarePrecise algorithmically derived* exclusive). The NPI and CoLoCode comprise the dual relational key for this table. The NPI identifies the provider record, and the CoLoCode identifies the U.S. physical location. 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.   Relational Key (composite) 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. CoLoCodes are created for Practice addresses in the United States (US) and US Minor Islands (UM).   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 location.   CPAC tAdded CPAC records only. Table is not provided in custom data pulls (CarePrecise Select services) (MDB and CSV formats) NPI National Provider Identifier Relational Key (composite) DateDiscovered   Relational Key (composite) 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. Unduplicative index key is dual; NPI and DateDiscovered.   CPAC tDropped CPAC records only. Table is not provided in custom data pulls (CarePrecise Select services) (MDB and CSV formats) NPI National Provider Identifier Relational Key (composite) DateDiscovered   Relational Key (composite) 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. Unduplicative index key is dual; NPI and DateDiscovered.   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   CPAC tExcluded (MDB and CSV formats) Table is not provided in custom data pulls (CarePrecise Select services) 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.   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. Not currently populated. CMS is not currently providing tax numbers. 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)   CPAC tDeact (MDB and CSV formats; CPAC records only) Table is not provided in custom data pulls (CarePrecise Select services)   NPI National Provider Identifier Relational Key (composite) This data is provided by CMS, listing all NPI records that have been deactivated and the deactivation date. Unduplicative index key is dual; NPI and DeactDate. Please note that a record may be added to the Deactivated tables, but then later be reactivated. Also note that Type 2 records (organizations) may have multiple records; some may be deactivated while others are active. When a record is reactivated it will appear in the tAdded table.   DeactDate Date CMS deactivated the provider's NPI record Relational Key (composite) DeactFound Date deactivation was processed by CarePrecise   DeactReason Reason for deactivation. Not currently populated. Not disclosed by CMS. CPAC Delta tables in NPPES_Delta.mdb (MDB format; CPAC records only) Table is not provided in custom data pulls (CarePrecise Select services) 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 near-complete data on those 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. Please note that a record may be added to the Deactivated tables, but then later be reactivated. Also note that Type 2 records (organizations) may have multiple records; some may be deactivated while others are active. When a record is reactivated it will appear in the tAdded table. Additional Data Included with CarePrecise Advanced™and CarePrecise Platinum. Data is sourced from PECOS, Physician Compare, Hospital Compare and other CMS data, and is updated monthly. Providers in the EPGH are a subset of the CPAC records, approximately 900,000 providers plus their practice groups and affiliated hospitals. EPGH tExtended_Professional (The EPGH is available optionally as a bundle with CarePrecise Access Complete (CPAC) that provides additional information on healthcare professionals (particularly physicians), practice groups and hospitals, and reveals the affiliation links between all three. MDB and CSV formats.) Only active providers (defined as having appeared on a Medicare claim in the past twelve months) are included in the EPGH dataset (unlike the CPAC dataset, which includes all US HIPAA-covered providers). EPGH data is available for approximately 615,000 physicians, and 300,000 other professionals, and is growing. The hospital data in EPGH provides an unduplicated listing of hospitals and their highest priority NPI number, and is linked to each hospital's affiliated professionals/physicians and practice groups. EPGH practice group data makes it possible to see the multiple locations at which an individual provider practices. NPI National Provider Identifier of Individual Professional Relational Key (composite and to CPAC) Link to professional's data in the CPAC databases above. This ID is unique per professional (physician, PA, etc.).   PACID Individual's unique PAC ID (Practice Access Code). Unique individual professional ID assigned by Medicare PECOS system Relational Key (composite) Link to practice group affiliations through the tExtended_GroupProfessional table, and is a link to upcoming practice group quality data.   ProfEnrollID Professional Enrollment ID Relational Key (composite) Unique ID for the individual professional enrollment that is the source for the data in the record. One professional may have multiple records in this table as a result of multiple PECOS enrollments, each of which may have its own hospital and practice group affiliations.   LN Last Name In most cases the name fields here will be duplicative of the fields in tHumanNames, but these are sourced from the PECOS system rather than the NPPES. FN First Name MN Middle Name Suffix Name Suffix (Jr, III, etc.) Gender M (male) or F (female)   Cred Credential Medical credential such as MD, DO, DPM, etc. School Professional's medical school   GradYear Professional's medical school graduation year   PriSpec Primary medical specialty reported by the individual professional in this PECOS enrollment record   AllSecSpec All four secondary specialties reported by the individual professional in this PECOS enrollment record, separated by commas   EPGH tExtended_Group (Extended Practice Group information; MDB and CSV formats) GroupPracPACID Unique Group Practice PAC ID (Practice Access Code) assigned by PECOS to the Group Practice Relational Key Links Group and Individual records within Extended tables. This ID is unique to each practice group. This key will link to group practice quality data soon to be released. NPI National Provider Identifier of the Practice Group Relational Key (to CPAC) Links practice groups in Extended tables to CPAC data above. Algorithmically derived*; not available for all group records. Use the GroupPracPACID to link individuals with their groups through the tExtended_GroupProfessional table. OrgLBN Legal name of the Group Practice   CountGroupPracMem Number of Individual Professionals affiliated with Group Practice This count is limited to individuals within the Extended domain; others may be found within the standard CPAC tables via CoLoCode. StreetAddr1 Group Practice line 1 address   StreetAddr2 Group Practice line 2 address   Line2Suppress Marker that address as reported may be incomplete A peculiarity of the federal source data. City Group Practice city   State Group Practice state   Zip Group Practice zip code (9 digits when available)   CoLoCode Derived algorithmically* based on location data May be used to identify additional affiliated individuals within the NPPES data above. See description of CoLoCode in the CPAC table tCoLoCode above.   HlthSysID RESERVED FOR LATER USE This is reserved for inclusion of the group's health system ID number. HlthSysName RESERVED FOR LATER USE This is reserved for inclusion of the group's health system name. EPGH tExtended_ GroupProfessional (Many-to-Many table linking group practices with individual professionals. One or more individuals per group, and may be one or more groups per individual. Extended information on group practices' individual providers, incl. whether accepts Medicare assignment, participates in various federal medical quality programs. MDB and CSV formats). Many-to-many table. NPI National Provider Identifier of the Individual Professional. Relational Key (composite and to CPAC) Link to individual's data in CPAC tables above and in tExtended_Professional table. This ID is unique to the individual professional. GroupPracPACID Unique Group Practice PAC ID (Practice Access Code) assigned by PECOS to the Group Practice that the individual professional works with. Relational Key (composite) Link between practice groups and their members in the tExtended_Professional table. This ID is unique to the practice group. AcceptsMedicareAsmt Y = Accepts Medicare approved amount as payment in full. M = May accept Medicare Assignment. All providers in this table are enrolled to bill Medicare, and have done so within the past 9 months, but may not still be accepting new Medicare patients, and may not accept Medicare amount as payment in full. eRx Participates in the eRx Incentive Program, a pay-for-reporting program to encourage physicians, other providers to use electronic prescribing of medications.     PQRS Participates in the Medicare Physician Quality Reporting System (PQRS) Incentive Program - a pay-for-reporting program that gives eligible professionals incentives and payment adjustments if they report quality measures satisfactorily. Quality data on individual professionals is not yet available in this product, but using the relational keys in this table, you will be able to access it when it is released. EPGH tExtended_Hospital (Extended information on all U.S. acute care, VA and children's hospitals. Data provides a single unique NPI number per hospital facilitating deduplication of hospital record. MDB and CSV formats) CCN Medicare Hospital Provider Number (CMS Certification Number assigned by CMS) Relational Key Link between hospitals and their affiliated individual physicians, etc. This ID is unique to each hospital recognized in the CMS PECOS system. If a hospital is eligible to bill Medicare (whether or not sanctioned), and is a general hospital (Acute Care, VA, Critical Access or Children's hospital), it is in this table. This key links to the exhaustive federal hospital quality data, optionally available for download at no cost to EPGH users. NPI Priority National Provider Identifier. Relational Key (to CPAC) Link to one of the hospital's records in CPAC tables above. Hospitals may have as many NPI numbers as they believe they need for their particular business circumstances, and tend to have many. We have listed here the Priority NPI, based on the hierarchical Taxonomy coding system, selecting first the NPI of the record containing the top (parent) taxonomy code for the hospital type, and, if not present, the NPI from the first-listed record for the hospital. Algorithmically derived*; not available for all hospital records. HospitalName Hospital name as reported by the hospital in its NPPES record From the PECOS database HospitalLBN Hospital legal business name as listed in hospital quality data From the Hospital Compare database Address1 Hospital line 1 address   Address2 Hospital line 2 address   City Hospital City   State Hospital State   Zip Code Hospital Zip Code   County Hospital County   Phone Phone   HospitalType Hospital Type, as recorded in hospital quality data   HospitalOwnership Hospital ownership structure   EmergencyService Y= Hospital has emergency service   CoLoCode Derived algorithmically* based on location data May be used to identify additional data within NPPES tables above. See description of CoLoCode in the CPAC table tCoLoCode above. EPGH tExtended_HospAff (1-to-Many table linking Hospitals with physicians and other providers; up to five hospitals per individual; MDB and CSV formats.) Many-to-many table. HospAffCCN Medicare CCN (CMS Certification Number assigned by CMS) of hospital where individual professional provides service Relational Key (composite) Link to hospital details in tExtended_Hospital via CCN, and to the CarePrecise Authoritative Hospital Database (APD) NPI Unique professional ID assigned by NPPES to Individual Professional affiliated with hospital Relational Key (composite) Link to Individual Professionals affiliated with hospital HospAffLBN Legal business name of hospital where individual professional provides service From the Hospital Compare database The ProCase™ module contains the Name and Address data in the CPAC dataset in properly-cased form. It is available as an add-on to the CarePrecise Complete (CPAC), CarePrecise Advanced, Gold or Platinum packages. ProCase is also available as a stand-alone product. ProCase tProCase_Names (Properly cased names from CPAC tHumanNames and tOrgNames tables.) NPI National Provider Identifier Relational Key (to CPAC) Link to data in the CPAC and EPGH databases above. CompanyName Name of organization   PN Provider Name Prefix Text   FN Provider First Name Text   MN Provider Middle Name Text   LN Provider Last Name Text   SN Provider Suffix Name Text   Cred Provider Credential Text   AttnName Provider or Organization contact person's full name; i.e., "Dr. Robert J. Jones, Jr., MD, PhD" Useful for professional communications Salutation AI-generated salutation (the greeting on a letter; i.e., Dear "Mrs. Smith" or "Ms. Doe" or "Dr. Jones" Useful for professional communications Title Provider Title Text   EntityType 1 = individual, 2 = organization   PrimarySpecialty/Facility NOTICE: Starting with the June 30, 2022 release, specialty and facility will no longer be included in ProCase. The description of the provider's primary specialty if a Type 1 record (individual practitioner), or facility type if a Type 2 record (organization). Organizations may have multiple Type 2 records, so the record used is chosen algorithmically*. Type 2 record is chosen algorithmically* ProCase tProCase_Addresses_Mail (Properly cased Mailing Addresses from CPAC tAddresses table.) NPI National Provider Identifier Relational Key (to CPAC) Link to data in the CPAC and EPGH databases above. Addr1 Mailing address line 1   Addr2 Mailing address line 2   City Mailing address city   State Mailing address state   Zip Mailing address Zip Code   Country Mailing address country   ProCase tProCase_Addresses_Prac (Properly cased Practice Addresses from CPAC tAddresses table.) NPI National Provider Identifier Relational Key (to CPAC) Link to data in the CPAC and EPGH databases above. Addr1 Practice address line 1   Addr2 Practice address line 2   City Practice address city   State Practice address state   Zip Practice address Zip Code   Country Practice address country   The Authoritative Physician Database™ (APD) contains detailed data on all HIPAA-covered US physicians, including practice group and hospital affiliations, medical procedure volumes, etc. The Authoritative Physician Database is available separately, but can be linked to the CarePrecise Complete (CPAC), CarePrecise Advanced, and Authoritative Hospital Database data keying on the NPI, PACID, and CCN fields. Note that neither CarePrecise Platinum, CarePrecise Gold, CarePrecise Complete, or CarePrecise Advanced include the APD. APD APD_Physician All U.S. HIPAA-covered physicians. NPI National Provider Identifier assigned by the federal government to every HIPAA-covered healthcare provider. All physicians are required to have one, and only one, Type 1 NPI number. Relational Key PhysPACID Unique Physician ID assigned by PECOS Relational Key (to EPGH) LN Last name   FN First name   MN Middle name   PN Name Prefix (Dr, Ms, etc.)   SN Name Suffix (Jr, II, etc.)   Cred Credential(s)   Prac1stAddr Practice address line 1   Prac2ndAddr Practice address line 2   PracCity Practice address city   PracState Practice address state   PracZip Practice address Zip Code   County Practice address county   CoLoCode Practice co-location code; may be used to link providers practicing at the same location; derived algorithmically based on co-location data   Rural/Urban/Sub R = Rural, U = Urban, S = Suburban/other   PhysicianPracPhone Physician's Practice phone number   PhysicianFax Fax number   EnumDate Date provider registered with the federal NPI database   UpdateDate Date provider most recently updated their NPI record   Gender Provider's gender   IsSoleProp Y = sole proprietor business type   IndepProfile Y = physician's profile indicates independent practice or group of 3 or fewer   InPECOS Y = enrolled to bill Medicare (may order and refer)   Warning Y = physician is barred from billing Medicare due to an infraction   ExclType Code of the infraction (see the ExclCode table for definitions)   PriSpec Primary medical specialty from NPI Type 1 record (NOTE: All specialties are listed in APD_Specialty)   School Physician's medical school   GradYear Physician's medical school graduation year   EstPracYears Estimated number of years in practice; used to estimate physician's age Based on medical school graduation year or date of NPI enumeration. APD APD_Physician_Type2 All U.S. HIPAA-covered physicians. NPI National Provider Identifier (Type 2) assigned by the federal government to a physician's business entity. Every physician is required to have one and anly one Type 1 (individual) NPI registration, but may have additional Type 2 (organization) NPI registrations. Relational Key OrgName_LBN Legal Business Name of physician's business entity   LN Last name of authorized official for physician business entity   FN First name of authorized official for physician business entity   MN Middle name of authorized official for physician business entity   PN Name Prefix (Dr, Ms, etc.) of authorized official for physician business entity   SN Name Suffix (Jr, II, etc.) of authorized official for physician business entity   Cred Credential(s) of authorized official for physician business entity   Title Title of authorized official for physician business entity   Prac1stAddr Practice address line 1   Prac2ndAddr Practice address line 2   PracCity Practice address city   PracState Practice address state   PracZip Practice address Zip Code   County Practice address county   CoLoCode Business entity's co-location code, derived algorithmically based on co-location data   Rural/Urban/Sub R = Rural, U = Urban, S = Suburban/other   PhysicianPracPhone Business entity phone number   PhysicianFax Business entity fax number   EnumDate Date provider registered this Type 2 NPI enumeration with the federal NPI database   UpdateDate Date provider most recently updated this Type 2 NPI record   IsSoleProp Y = sole proprietor business type   InPECOS Y = enrolled to bill Medicare (may order and refer)   Warning Y = physician is barred from billing Medicare due to an infraction   ExclType Code of the infraction (see the ExclCode table for definitions)   PriSpec Primary medical specialty from business entity's NPI Type 1 record (NOTE: All specialties are listed in APD_Specialty)   APD APD_Specialty All physicians' specialties. May be up to 15 per physician. NPI National Provider Identifier Relational Key ReportedOrder Number of taxonomy field in which reported (1 - 15), same as Tnum field in CPAC.tTaxo   Taxonomy Taxonomy code   License License number   LicenseState Licensing state   IsPrimary Y = primary taxonomy code (primary specialty)   Specialty Taxonomy description, i.e., specialty   APD APD_Group Physicians' affiliated practice groups. May be up to five per physician. Ongoing extraction from Medicare claims data. NOTE: Medical procedure performed per group can be viewed as a summary of procedures performed by each group's affiliated physicians. See example query in AuthoritativeHospDB.mdb. PACID Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with Relational Key (composite) NPI Group National Provider Identifier; derived algorithmically from NPI registry data; groups may have additional NPI numbers Relational Key OrgLBN Legal name of the Group Practice   CountGroupPracMem Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID   StreetAddr1 Group Practice line 1 address   StreetAddr2 Group Practice line 2 address   City Group Practice city   State Group Practice state   Zip Group Practice zip code (9 digits when available)   County Group Practice County   Rural/Urban/Sub R = Rural, U = Urban, S = Suburban/other   CoLoCode Group co-location code; may be used to link providers practicing at the same location; derived algorithmically based on co-location data   GroupPhone Phone Number   GroupFax Fax Number   AuthPN Contact name prefix   AuthFN Contact first name   AuthMN Contact middle name   AuthLN Contact last name   AuthSN Contact name suffix   AuthCred Contact credential   AuthTitle Contact title   APD APD_GroupAff Linking table connects physicians with practice group affiliations. Collected from Medicare claims data during a moving window of twelve months prior to release date. NPI Unique physician ID assigned by NPPES Relational Key (composite) PACID Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with Relational Key (composite) AcceptsMedicareAsmt Y = Professional accepts Medicare approved amount as payment in full at this group location. M = Professional may accept Medicare Assignment.   APD APD_Hospital Physician's affiliated hospitals. May be up to five per physician. Ongoing extraction from Medicare claims data. CCN CMS Certification Number Relational Key NPI Priority National Provider Identifier of hospital; derived as best NPI based on taxonomy hierarchy; hospitals may have additional NPI numbers Relational Key (to CPAC) HospitalName Hospital name as reported by the hospital in its NPPES record   HospitalLBN Hospital legal business name as listed in the hospital quality data   Address1 Hospital line 1 address   Address2 Hospital line 2 address   City Hospital City   State Hospital State   ZIP Code Hospital Zip Code   County Hospital County   Rural/Urban/Sub R = Rural, U = Urban, S = Suburban/other   HospitalPhone Hospital Phone   HospitalFax Hospital Fax Number   HospitalType Hospital Type, as recorded in hospital quality data   HospitalOwnership Hospital ownership structure   EmergencyService Y= Hospital has emergency service   CoLoCode Hospital co-location code; may be used to link providers practicing at the same location; derived algorithmically based on co-location data   AuthPN Contact name prefix   AuthFN Contact first name   AuthMN Contact middle name   AuthLN Contact last name   AuthSN Contact name suffix   AuthCred Contact credential   AuthTitle Contact Official title   APD APD_HospitalAff Linking table connects physicians with their hospital affiliations. Collected from Medicare claims data during a moving window of twelve months prior to data release date. CCN CCN of hospital where individual professional provides service Relational Key (composite) NPI Unique physician ID assigned by NPPES Relational Key (composite) APD APD_PhysicianProcedure Physician procedure volumes, listing top five procedures performed by physician, and counts of services and patients served, from CMS-collected HCPCS reporting. NPI National Provider Identifier of clinician Relational Key (composite) HCPCS_Code Healthcare Common Procedure Coding System (HCPCS) procedural code billed by the clinician; "NR" indicares that no procedure data has been reported for this physician. Top five HCPCS procedures performed by physician are listed. Relational Key (composite) to Physician Procedure table ServiceCount Frequency of individual clinician's performance of the associated HCPCS code within the calendar year   BeneficiaryCount The number of patients that received the procedure identified by the HCPCS code   MeasureYear The most recent year of procedure data reported by CMS   APD APD_ProcedureDescriptions Physician procedure volumes. Ongoing extraction from CMS-collected HCPCS reporting. Abbreviated descriptions. HCPCS_Code Healthcare Common Procedure Coding System (HCPCS) procedural code billed by the clinician Relational Key to Physician Procedure table ProcedureDescription Lay-friendly description of procedure associated with HCPS code (abbreviated)   APD Lookup_ExclusionDescriptions Describes the exclusion code for sanctions indicated in the APD_Physician table. Exclusion from billing Medicare or other federal programs due to a sanction of other infraction. Sourced from Centers for Medicare and Medicaid Services Office of Inspector General. ExclType Exclusion type code Relational Key to ExclType in Physician table ExclDescr Description of exclusions imposed by the OIG expanded from Medicare and State health care programs to all Federal health care programs, federal code 1128B(f)(1).   APD tAPD_PhysicianDMEPOS DME and POS (durable medical equipment, prosthetics; and orthotics and supplies) orders submitted by physician NPI National Provider Identifier of clinician Relational Key (composite) HCPCS_Code Healthcare Common Procedure Coding System (HCPCS) DEMPOS order code billed by the clinician Relational Key (composite) Rental Indicates if the DMEPOS item is a rental. Orders may be for purchase, for rental, or both (which will be shown as two separate records) Relational Key (composite) Suppliers Number of suppliers who provided the item   Beneficiaries Number of patients who received the item identified by the HCPCS code   Claims Number of claims submitted for the item   Services Total number of orders   AvgSubmittedCharge Average of charges submitted for this item   AvgMedicareAllowAmount Average of Medicare allowed amounts for orders of this item   AvgMedicarePaymentAmount Average of Medicare's payments for this item   AvgMedicareStandardAmount Average of Medicare's "standard" payment amount   MeasureYear Year for which data is reported   APD tAPD_PhysicianDMEPOS Physician DMEPOS order volumes. Ongoing extraction from CMS-collected HCPCS reporting. Abbreviated descriptions. HCPCS_Code Healthcare Common Procedure Coding System (HCPCS) DEMPOS order code billed by the clinician Relational Key to Physician DMEPOS table DMEPOS_Description Lay-friendly description of DMEPOS order associated with HCPS code (abbreviated)   The Authoritative Hospital Database™ (AHD) contains detailed data on US hospitals, including bed counts, procedure volumes, medicare billings, patient satisfaction rankings, etc. The Authoritative Hospital Database is available separately, but can be linked to CarePrecise Complete (CPAC), CarePrecise Advanced, and Authoritative Physician Database data keying on the NPI, PACID and CCN fields. Note that neither CarePrecise Platinum, CarePrecise Gold, CarePrecise Complete or the CarePrecise Advanced include the AHD. AHD tAnalysis_Hospital Data related to a particular hospital. CCN Unique federal hospital identifier Relational Key (to EPGH) Link to data in the EPGH databases above. NPI National Provider Identifier Relational Key (to CPAC) Link to data in the CPAC and EPGH databases above. Algorithmically derived*; not available for all AHD records. The contact name fields in the AHD are then populated from the matched NPI record. HospitalName Hospital’s name   Address1 Hospital’s address, line 1   Address2 Hospital’s address, line 2   City Hospital’s city   State Hospital’s state   ZipCode Hospital’s Zip Code   County Hospital’s county   Phone Hospital’s phone   Fax Hospital’s fax   Beds Number of beds   BedDaysAvail Number of bed days available   InternsAndResidents Number of interns and residents   PayrollEmployees Number of employees on payroll   NonPaidWorkers Number of non-paid workers   TotalDischarges Number of discharges/year   MedicareDischarges Number of Medicare discharges/year   MedicaidDischarges Number of Medicaid discharges/year   Vol_Gastrointestinal Procedure volume: Gastrointestinal   Vol_Eye Procedure volume: Eye   Vol_Nervous_system Procedure volume: Nervous system   Vol_Musculoskeletal Procedure volume: Musculoskeletal   Vol_Skin Procedure volume: Skin   Vol_Genitourinary Procedure volume: Genitourinary   Vol_Cardiovascular Procedure volume: Cardiovascular   PN Contact name prefix   FN Contact first name   MN Contact middle name   LN Contact last name   SN Contact name suffix   Title Contact title   Cred Contact credentials   HospitalType Type of hospital (general acute, children's, etc.)   HospitalOwnership Type of hospital ownership   ParentOrgLBN Name of parent system   EmergencyService Does have emergency service?   CoLoCode Algorithmically derived* from location data. Used to match records.   Bathroom cleanliness Patient satisfaction 1-5 stars   Communication from Nurses Patient satisfaction 1-5 stars   Communication from Doctors Patient satisfaction 1-5 stars   Patient received help quickly on request Patient satisfaction 1-5 stars   Quality of pain control Patient satisfaction 1-5 stars   Medications were explained before giving Patient satisfaction 1-5 stars   Patient received instruction on at-home recovery Patient satisfaction 1-5 stars   Patient understood care when leaving hospital Patient satisfaction 1-5 stars   Patient’s overall hospital rating Patient satisfaction 1-5 stars   Area around room was quiet at night Patient satisfaction 1-5 stars   Patient would recommend hospital Patient satisfaction 1-5 stars   Hospital summary star rating Patient satisfaction 1-5 stars   HlthSysID Unique ID representing the parent system   HlthSysName Name of the health system parent to which the hospital belongs   MSA/CBSA MSA/CBSA of hospital location   Population Population of hospital's location zip code   Rural/Urban Hospital is located in a Zip Code considered rural (R) or urban (U)   AHD tAnalysis_System HlthSysID Unique ID representing the parent system Relational Key to hospital record in tAnalysis_Hospital HlthSysName Name of the health system parent to which the hospital belongs   HlthSysCity City of parent system   HlthSysState State of parent system   HlthSysPhys Total number of health system primary care physicians   HlthSysPCPhys Number of health system primary care physicians   HlthSysResidents Number of Residents across health system   HlthSysGroups Number of practice groups in the health system   HlthSysHospitals Number of hospitals in the health system   HlthSysAcuteCare Number of acute care hospitals in the health system   HlthSysBeds Number of beds across health system   HlthSysStates Number of states in which health system operates   HlthSysDischarges Number of discharges across health system   HlthSysHighUCCB True = Health System has a high uncompensated care burden   HlthSysInvestorOwned True = Health System is predominantly investor-owned   AHD tHospServiceArea CCN Unique federal hospital identifier Relational Key to hospital record in tAnalysis_Hospital Zip_Hospital Hospital zip code   Zip_Patient Patient residence zip code   DaysOfCare Days of care provided to patients residing in Zip_Patient   TotalCharges Total charges for patients residing in Zip_Patient in Dollars   TotalCases Total cases for patients residing in Zip_Patient   MSA MSA of hospital location   Rural/Urban_Patient Patient is located in a Zip Code considered rural (R) or urban (U)   Additional data included in the CP ListMaker software component of CarePrecise Gold, and CarePrecise Platinum, sourced from USPS and U.S. Department of Commerce, and independent CarePrecise research. Data is periodically updated. These data are available only as part of the CP ListMaker and CarePrecise Gold/Platinum products, and are not sold separately. Note that only the tZips data, and not the CP ListMaker application itself, is included in special licensing for Derivative Products or Redistribution; however, the CP ListMaker application is open source and may be used as a model for redistributed products. CPLM tZips Economic and social segmentation data for providers' service areas ZipCode 5-digit Zip Code Relational Key (to CPAC.tEntity.Zip5) Wealth Numerical indicator of the relative wealth/poverty of the provider's immediate service area (5-digit 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   Latitude Geographic latitude to 5-digit zip accuracy (center of Zip)   Longitude Geographic longitude to 5-digit zip accuracy (center of Zip)   CPLM Additional Gold data tables: - Names - Names_Company - Names_Cred - Names_Genderize - Names_Prefices - Names_Suffices - StateNameVariants     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.   Printer-friendly version of the fields listing. * Marked above by an asterisk (*), algorithmically derived data in the datasets 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, some of the older 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. See the disclaimer appearing at the bottom of the documentation page. Not all fields in all records are populated with data. Healthcare providers may update data in their record using the federal NPI registry website, and are required to do so within 30 days of a change in their information. CarePrecise LLC reserves the right to make changes in the data and data structure as it deems necessary to preserve the quality of the product. Please read the Notice at the bottom of the page https://www.careprecise.com/help/ for additional information about the data.

How To Use the Relational Database

To use the CSV or MDB files, which are organized as a relational database linked by the NPI number in most cases, you will need to use a relational database management software, such as Microsoft Access (part of Office) version 2007 or later, FileMaker, or other product. If you are using Microsoft Access, open the file named NPPES_core.mdb if you are using only the CarePrecise Complete (CPAC), Select or State product, or Extended_core.mdb if you are using the master bundle product.

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.

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 design virtually eliminates query failures. The data is authoritative because 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.

The NPPES (National Provider and Plan Enumeration System, maintained by Centers for Medicare and Medicaid Services, is one of the most accurate resources form provider data. Providers are required by law to update their record within thirty days of a change. No database is perfect; however, the NPPES gets high marks in recent studies.

"NPPES and SK&A had the highest rates of matching mailing address information, while the AMA Masterfile had low rates compared with the NPPES... the NPPES and to a lesser extent, the SK&A file, appear to provide reasonably accurate, up-to-date address information for physicians billing public and [private] insurers."

"The Results Are Only as Good as the Sample: Assessing Three National Physician Sampling Frames," Journal of General Internal Medicine. 2015. Catherine M. DesRoches, Dr.P.H., et al.

The NPPES database scored best at 94% accuracy, the SK&A at 92%, while the AMA Masterfile had significantly lower rates of correct address information across all specialties scoring only 54%. That said, CarePrecise goes beyond the NPPES data, merging in provider name and address information extracted from millions of Medicare claims through a 12-month window, offering additional practice location and group affiliation data that is frequently the most up-to-date available, surpassing our competitors' offerings and even the AMA Masterfile and online provider network directories of some of the nation's largest health insurance plans.

Solid, comprehensive, and authoritative, CarePrecise products are used to create and update network directories, to investigate fraud, waste, and abuse across the healthcare industry, to organize clinical and market research, and in a broad variety of Web applications. Licensing is available for all of these special uses.

Because CarePrecise does not control the data content; products are offered as-is and no warranty as to accuracy, timeliness, or fitness for a particular purpose is expressed or implied.*

Historical HCP Data

Two historical databases are included in the CarePrecise Complete data distribution, the NPPES_Deact and NPPES_Delta, to provide historical information on providers. 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 include complete data on the deactivated provider records, showing all of the data from the CarePrecise Complete dataset, going back to 2011.Another table, NPPES_Added, provides historical dates of when all providers, even those deactivated from the current database, were first added to the system. Each record in the NPPES_Delta tables represents a rich 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 above for descriptions of the delta tables.

An additional specialized product, the Physicians' Sanctions, Reinstatements, Deactivations and Reactivations (SRDR) Database, is also available for use in determining a physician or other healthcare provider's eligibility to bill insurance at a given point in time going back to 2009. Not included in the standard products listed here, the SRDR includes not only dates of activation and deactivation, but also dates of exclusions (sanctions) and reinstatements, along with reasons for the exclusions. Pricing can be found on the Historical Data page. Contact us for additional information on the SRDR.

Added & Dropped Provider Records

These two data tables are generated by CarePrecise and included in the CarePrecise 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 basic name and contact information, as well as the NPI number.

Group CoLoCode™ 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. This particular data is extracted every month from Medicare claims, and represents a moving 12-month window on individuals' group affiliations. We provide both a "Group" flag in the provider's data, and relational table with the reported codes (tTaxoGroup).

The second tool we provide to identify groups is the co-location code table (tCoLoCode). The CoLoCode is an algorithmic derivation from provider practice data, which facilitates querying providers by practice location. Our QoRelate™ 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.

The most reliable method for identifying group practices' members is provided in the EPGH dataset, which captures individual and group links from Medicare claims.

File Formats

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

• Microsoft Access (.mdb); normalized relational tables, plus a central core database with query examples
• Comma Separated Values (.csv), supporting FileMaker, MySQL, MSSQL and other database systems, on Windows, Mac or Linux, in normalized relational tables

The CP ListMaker component of CarePrecise Platinum and CarePrecise Gold requires Microsoft Access 2007 or later.

You can use built-in utilities in the MDB application to export the data in most common data formats, including CSV, TXT, MDB, ACCDB and others. Application extensions are available for conversion to MySQL, among other formats. Conversion to MSSQL is done within SQL Server.

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.

Reports

Use the NPPES_Core.mdb database application included with the CarePrecise package in Microsoft Access 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 software application for preparing and exporting lists, Excel output, or reports without database skills, see CarePrecise Gold or CarePrecise Platinum.

Understanding National Provider Identifier (NPI) 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.

Using in Microsoft Access

With more than 7.1 million rows of provider data, and because the database is organized in a normalized relational format, a database application is the ideal environment for use. We provide a "core" database shell that links all of the table files together into a single database environment for use in Microsoft Access. For the CarePrecise Complete dataset only, use the file named NPPES_Core.mdb. For CarePrecise Advanced (CPAC + EPGH datasets), use the file named Extended_Core.mdb. MDB files, rather than ACCDB files, are provided to offer better backward compatibility with Microsoft Access versions, but is subject to be changed to ACCDB format in the future. The CP ListMaker component of CarePrecise Platinum and CarePrecise Gold is a powerful tool for extracting specific types of providers by a wide range of criteria, including geographic location, specialty, gender and other data points.

Microsoft Access Alternatives

Don't have Microsoft Access, but want to use the full 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 compatible 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).

Using in Microsoft Excel

Because these files contain more than the number of records that Excel can open, you will need to use the Excel Power Pivot add-in if you wish to view all of the more than 7.1 million rows. (Power Pivot is not required to use Excel files having fewer than 1,048,576 records exported from the Gold or Platinum CP ListMaker application.) The Power Pivot add-in has distributed with Excel since the 2013 version, but Excel 2010 can use Power Pivot add-in as well, available as a free download from Microsoft. However, Excel is decidedly not the best method for working with the full database of 7.1 million records; rather, a Database Management System (DBMS), such as Microsoft Access (part of Microsoft Office Pro and Office 365), FileMaker Pro, and other database software.

Licensing

CarePrecise data is single-user licensed for use by the purchaser and may not be redistributed in any form and may not be exposed in full or in part by any means including a website without special licensing. Review the Single User License Agreement here. Learn about special licensing on the Licensing page, and contact CarePrecise Sales for information.

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 advanced 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 2007 or later is required. You should have a minimum of 4 gigabytes of RAM. Approximately 6GB of disk space should be allotted for storage of the MDB files, plus additional disk space when manipulating the data. The CSV files may be imported into any application that supports comma separated value files and supports more than 8 million rows of data.

Technical Support

Different CarePrecise product packages come with different levels and periods of free technical support. Refer to the support page for details. Paid advanced 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.

Understanding Algorithmically Derived Fields

In order to bring additional functionality to a dataset, it is often necessary to create a datapoint that doesn't exist in the source data, and use an algorithm to populate it based on existing data. For instance, in order to find all of the records located at the same physical address – data which may be "fat fingered" or entered in various different ways – an algorithm can be used to "clean up" location data and create a new field. Such is the case with the CarePrecise CoLoCode™ field.

In another instance, CarePrecise uses an algorithm to get an NPI number into the available PECOS data of practice groups and hospitals (in the EPGH dataset) so that it can be used (judiciously) to link to an organization's record in the CarePrecise Complete (CPAC) dataset. Because a "fuzzy logic" algorithm is used to find the NPI, some errors do occur, so that not every populated organization NPI in the EPGH or AHD datasets will be a correct one. The process involves comparing existing data between the EPGH's fields and the CPAC's field to match the organization with its NPI record (a process known as "record linkage") The algorithm gets smarter over time, but it can never be trusted to provide complete accuracy. If the group or hospital data in the EPGH is insufficient, the NPI number provided by CarePrecise can be used to view the more complete NPI record in the CPAC (or better in many cases, the CoLoCode), with the proviso that relying on automation alone may produce mismatched records.