Dataset logo

NPPES

Dataset logo
Dataset logo

NPPES

By CMS

National Plan and Provider Enumeration System

Type

Dataset

Update frequency

Monthly

Updated

Sep 15, 2021

Delivery method

Download

The Center for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) was created as part of the Administrative Simplification provisions in the original Health Insurance Portability and Accountability Act (HIPAA) act. The primary purpose of NPPES was to develop a unique identifier for each physician that billed Medicare and Medicaid.

This identifier is now known as the National Provider Identifier Standard (NPI) which is a required intelligence-free numeric identifier (10 digit number) that is unique to an individual provider at the national level. This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.

As outlined in the Federal Regulation, HIPAA, covered providers must also share their NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes.

The CMS now included in the dataset the deactivated NPIs.

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