Base Provider Enrollment File

$447.50 / year

This dataset shows a point in time snapshot of enrollment level data for providers actively enrolled in Medicare for the year 2018.

Complexity

The Provider Enrollment, Chain, and Ownership System (PECOS) is an online Medicare enrollment system where providers and suppliers can:
– Submit Medicare enrollment applications
– View and print enrollment information
– Update enrollment information
– Complete the enrollment revalidation process
– Withdraw from the Medicare Program voluntarily
– Track the status of a submitted Medicare enrollment application

The Public Provider Enrollment data for Medicare fee-for-service includes providers who are actively approved to bill Medicare or have completed the 855O at the time the data was pulled from the Provider Enrollment and Chain Ownership System (PECOS). The release of this provider enrollment data is not related to other provider information releases such as Physician Compare or Data Transparency.

These files are populated from PECOS and contain basic enrollment and provider information, reassignment of benefits information and practice location city, state and zip. These files are not intended to be used as real-time reporting as the data changes from day to day and the files are updated only on a quarterly basis. If any information on these files needs to be updated, the provider needs to contact their respective Medicare Administrative Contractor (MAC) to have that information updated.

Date Created

2016-01-27

Last Modified

2019-04-09

Version

2019-04-09

Update Frequency

Irregular

Temporal Coverage

2019

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

PECOS, Physician Enrollment, Provider Enrollment Data, Medicare Enrollment, Enrollment Application, Medicare Enrollment Application, Public Provider Enrollment Data, Provider Information

Other Titles

Providers Actively Enrolled in Medicare, Medicare Enrollment System, Medicare Providers and Suppliers 2019

NameDescriptionTypeConstraints
NPIUnique professional ID assigned by National Plan and Provider Enumeration System (NPPES)string-
PECOS_Control_IDUnique individual professional ID assigned by PECOSstring-
Enrollment_IDUnique ID for the individual professional enrollment that is the source for the data in the observationstring-
Provider_Type_CodeProvider Type Code Assigned to Provider with respect to specialtystring-
Provider_TypeSpecialty of the Providerstring-
Provider_Type_DescriptionDescription of the Specialty of the Providerstring-
State_AbbreviationState abbreviation of the providerstring-
First_NameProvider professional first namestring-
Middle_NameProvider professional middle namestring-
Last_NameProvider professional last namestring-
Organization_NameName of the Provider's organizationstring-
GenderProvider professional gender M/Fstring-
NPIPECOS Control IDEnrollment IDProvider Type CodeProvider TypeProvider Type DescriptionState AbbreviationFirst NameMiddle NameLast NameOrganization NameGender
10038798838022920719I2003110300000114-16PRACTITIONEROBSTETRICS/GYNECOLOGYPRANTONIOALVAREZ RODRIGUEZM
10039769867113839812I2003110300000514-68PRACTITIONERPSYCHOLOGIST, CLINICALPACHRISTOPHERJZIEGLERM
14078021198022920727I2003110300000714-93PRACTITIONEREMERGENCY MEDICINEPAKADISHABRAPPF
18311650755193637890I2003110300001314-16PRACTITIONEROBSTETRICS/GYNECOLOGYPRJORGEAOSTOLAZA BEYM
18513572142466364161I2003110300001414-30PRACTITIONERDIAGNOSTIC RADIOLOGYKYRHONDAGGRISSOMF
10837669355092627794I2003110300001514-35PRACTITIONERCHIROPRACTICNJTIMOTHYJDIECKMANM
10838351775991617698I2003110300002014-41PRACTITIONEROPTOMETRYNJANNAMOYF
17202979637618889312I2003110300002814-26PRACTITIONERPSYCHIATRYNJDAMONDDELSTONM
14978811891254243959I2003110300003014-01PRACTITIONERGENERAL PRACTICEPRELVIAAYALAF
14371555209234041930I2003110300003214-68PRACTITIONERPSYCHOLOGIST, CLINICALMIARNOLDWEINGARDENM