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Practice Management & Allied Staff News & Materials

Dissemination of data from NPPES to begin September 4, 2007

August 8th, 2007

National Plan and Provider Enumeration System (NPPES) health care provider data that are disclosable under the Freedom of Information Act (FOIA) will be disclosed to the public by the Centers for Medicare & Medicaid Services (CMS). In accordance with the e-FOIA Amendments, CMS will be disclosing these data via the Internet.

Data will be available in two forms:

  • A query-only database, known as the NPI Registry
  • A downloadable file

    CMS is extending the period of time in which enumerated health care providers can view their FOIA-disclosable NPPES data and make any edits they feel are necessary prior to our initial disclosure of the data.

    Time must be built in to resolve any errors or problems that may be encountered with edits that health care providers submit. Therefore, in order to ensure edits are reflected in the NPI Registry when it first becomes operational and in the first downloadable file, health care providers need to submit their edits no later than Monday, August 20, 2007. Health care providers who submit edits on paper need to ensure that they are mailed in time for receipt by the NPI Enumerator by that date.

    CMS will be making FOIA-disclosable NPPES health care provider data available beginning Tuesday, September 4, 2007. The NPI Registry will become operational on September 4 and the downloadable file will be ready approximately one week later.

    Health care providers should refer to the document entitled, "Information on FOIA-Disclosable Data Elements in NPPES," dated June 20, 2007 (found on the CMS NPI web page) for assistance in making their edits. Some of the key data elements that are FOIA-Disclosable are:

    • NPI
    • Entity Type Code (1-Individual or 2-Organization)
    • Replacement NPI
    • Provider Name (First Name, Middle Name, Last Name, Prefix, Suffix, Credential(s), OR the Legal Business Name for Organizations)
    • Provider Other Name (First Name, Middle Name, Last Name, OR "Doing Business As" Name, Former Legal Business Name, Other Name. for Organizations)
    • Provider Business Mailing Address (First line address, Second line address, City, State, Postal Code, and Country Code if outside U.S., Telephone Number, Fax Number)
    • Provider Business Location Address (First line address, Second line address, City, State, Postal Code, and Country Code if outside U.S., Telephone Number, Fax Number)
    • Healthcare Provider Taxonomy Code(s)
    • Other Provider Identifier(s)
    • Other Provider Identifier Type Code
    • Provider Enumeration Date
    • Last Update Date
    • NPI Deactivation Reason Code
    • NPI Deactivation Date
    • NPI Reactivation Date
    • Provider Gender Code
    • Provider License Number
    • Provider License Number State Code
    • Authorized Official Contact Information (First Name, Middle Name, Last Name, Title or Position, Telephone Number)

    The delay in the dissemination of NPPES data does not alter the requirement that HIPAA covered entities must comply with the requirements of the NPI Final Rule no later than May 23, 2008. All NPI contingencies that may be in place must be lifted by that date.

    As always, more information and education on the NPI can be found through the CMS NPI page on the CMS website. Providers can apply for an NPI online or can call the NPI enumerator to request a paper application at 1-800-465-3203.