Fred Trotter

Healthcare Data Journalist

Uncategorized

The MD Problem in NPPES

I am at the ONC Provider Directory 2019 Workshop. Here, I needed to quickly illustrate the problem with the NPPES broadcast of Credential Information. This blog post was the result.

Credentialing is generally agreed to be out-of-scope for NPPES, however NPPES *does* accept free-text credential information. As a result of this, people type in basically whatever they want in this field. No validation or normalization is done on this field, and as a result NPPES broadcasts irreconcilable credential information. This means that NPPES does not solve or take responsibility for this data, but because of what it does choose to do, it makes it much harder for downstream systems to sort things out.

We have studied the free-text information in the NPPES credentialing fields for years (there are two fields for.personal credentials in the NPPES data download). What follows is a quick analysis of the contents of this study, for the purposes of reading out to the rest of the ONC Directory 2019 meeting…

I am discussing the problem of credentialing data in NPPES. Here is the public search tool for NPI which does not allow for searching by credentialing field.

Here is the mapping between provider type in PECOS and NPPES

https://data.cms.gov/Medicare-Enrollment/CROSSWALK-MEDICARE-PROVIDER-SUPPLIER-to-HEALTHCARE/j75i-rw8y/data

Here is the Argonaut Provider Directory Provider Specialty (NUCC) which is a permutation of the NUCC taxonomy standard that is used in NPPES.