Base Provider Enrollment File

$199 / 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

2018-05-03

Version

2018-05-03

Update Frequency

Irregular

Temporal Coverage

2018

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare and Medicaid Services

Source License URL

John Snow Labs Standard License

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 2018

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_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-
GenderProvider professional gender M/Fstring-
NPIPECOS_Control_IDEnrollment_IDProvider_Type_CodeProvider_Type_DescriptionState_AbbreviationFirst_NameMiddle_NameLast_NameGender
171097435742116683I2003121200028214-13PRACTITIONER - NEUROLOGYNYJINLIF
11947438649537058508I2004031500133214-34PRACTITIONER - UROLOGYCASYTSIM
13565632336305894874I2005011100074814-48PRACTITIONER - PODIATRYCAKYHOM
151824688342482333I2011101000054214-41PRACTITIONER - OPTOMETRYMAYANLUF
125543478342468936I2012091800090114-22PRACTITIONER - PATHOLOGYOKLEOLUM
18312011282860390390I2003122200061814-34PRACTITIONER - UROLOGYILNINGWUM
16493587302062308265I2004022500022714-34PRACTITIONER - UROLOGYCAJOHNOHM
11149522568729990387I2004041400012114-34PRACTITIONER - UROLOGYILLSFLOMF
10331201182860478658I2004062400049714-48PRACTITIONER - PODIATRYCAKISYIM
17707435938022081702I2004081900086514-22PRACTITIONER - PATHOLOGYFLSUXUF