Medicare Physician National Downloadable File

$395 / year

The National downloadable file is organized at the individual provider level; each line is unique at the provider/enrollment/organization/address level. Providers with multiple enrollments and/or single enrollments linking to multiple practice location addresses are listed on multiple lines.

Complexity

These are the official datasets associated with the Medicare.gov Physician Compare Website provided by the Centers for Medicare & Medicaid Services (CMS). These data give useful information about the physicians and other healthcare professionals currently enrolled in Medicare. The Physician Compare National Downloadable file includes general information, such as demographic information and Medicare quality program participation, for individual eligible professionals (EPs). The Physician Compare 2013 Public Reporting downloadable file provides the 2013 Physician Quality Report System (PQRS) Group Practice Reporting Option (GPRO) performance rates for the three Diabetes Mellitus (DM) measures and one Coronary Artery Disease (CAD) measure now publicly reported on Physician Compare. Data are publicly available for the 139 group practices of 25 or more eligible professionals (EPs) that successfully reported data under the 2013 PQRS GPRO via the Web Interface. Also included in this file is information about which group practices participated in the eRx Incentive Program and the PQRS program. Because only Web Interface data are included, not all group practices that participated in PQRS under GPRO will have measure data in this file.

Date Created

2016-08-09

Last Modified

2018-10-18

Version

2018-10-18-07-19-07-05-06-14-05-31-05-17-05-03-04-19-04-05-03-22

Update Frequency

Biweekly

Temporal Coverage

2018

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare & Medicaid Services

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

CMS Centers for Medicare & Medicaid Services for Standard Reference, Release January 15th, 2016.

Keywords

Physician Compare, Group Practice Public Reporting, National Downloadable File, Physician Quality Report System (PQRS), Medicare Physician Files, Public Reporting Files, Public Downloadable Files, Electronic Health Record Files

Other Titles

National Downloadable File Free Data, National Downloadable File Enquiry, National Downloadable File Database Download

Name Description Type Constraints
NPIUnique professional ID assigned by NPPESstringrequired : 1
PAC_IDUnique individual professional ID assigned by PECOSstringrequired : 1
Professional_Enrollment_IDUnique ID for the individual professional enrollment that is the source for the data in the observationstringrequired : 1
Last_NameIndividual professional last namestring-
First_NameIndividual professional first namestring-
Middle_NameIndividual professional middle namestring-
SuffixIndividual professional suffixstring-
GenderIndividual professional gender M/Fstring-
CredentialMedical credential such as MD, DO, DPM, etc.string-
Medical_School_NameIndividual professional's medical schoolstring-
Graduation_YearIndividual professional's medical school graduation yeardate-
Primary_SpecialtyPrimary medical specialty reported by the individual professional in the selected enrollmentstring-
Secondary_Specialty_1First secondary medical specialty reported by the individual professional in the selected enrollmentstring-
Secondary_Specialty_2Second secondary medical specialty reported by the individual professional in the selected enrollmentstring-
Secondary_Specialty_3Third secondary medical specialty reported by the individual professional in the selected enrollmentstring-
Secondary_Specialty_4Fourth secondary medical specialty reported by the individual professional in the selected enrollmentstring-
All_Secondary_SpecialtiesAll four secondary specialties reported by the individual professional in the selected enrollment, separated by commasstring-
Organization_Legal_NameLegal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practicestring-
Group_Practice_PAC_IDUnique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practicestring-
Number_of_Group_Practice_MembersTotal number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID Digitsintegerlevel : Ratio
Line_1_Street_AddressGroup Practice or individual's line 1 addressstringrequired : 1
Line_2_Street_AddressGroup Practice or individual's line 2 addressstring-
Marker_of_Address_Line_2_SuppressionMarker that address as reported may be incompletestring-
CityGroup Practice or individual's citystringrequired : 1
StateGroup Practice or individual's statestringrequired : 1
Zip_CodeGroup Practice or individual's zip code (9 digits when available)stringrequired : 1
Phone_NumberPhone number or a contact numberstring-
Hospital_Affiliation_CCN_1Medicare CCN of hospital where individual professional provides servicestring-
Hospital_Affiliation_LBN_1Legal business name of hospital where individual professional provides servicestring-
Hospital_Affiliation_CCN_2Medicare CCN of hospital where individual professional provides servicestring-
Hospital_Affiliation_LBN_2Legal business name of hospital where individual professional provides servicestring-
Hospital_Affiliation_CCN_3Medicare CCN of hospital where individual professional provides servicestring-
Hospital_Affiliation_LBN_3Legal business name of hospital where individual professional renders servicestring-
Hospital_Affiliation_CCN_4Medicare CCN of hospital where individual professional renders servicestring-
Hospital_Affiliation_LBN_4Legal business name of hospital where individual professional provides servicestring-
Hospital_Affiliation_CCN_5Medicare CCN of hospital where individual professional provides servicestring-
Hospital_Affiliation_LBN_5Legal business name of hospital where individual professional provides servicestring-
Professional_Accepts_Medicare_AssignmentY = Professional accepts Medicare approved amount as payment in full M = Professional may accept Medicare Assignmentstring-
Participating_in_PQRSParticipates in the Medicare Physician Quality Reporting System (PQRS) Incentive Program - a pay-for-reporting program that encourages eligible professionals to report information about the quality of care they provide to people with Medicare who have certain medical conditionsstring-
Participating_in_EHRParticipates in the Medicare Electronic Health Record (EHR) Incentive Program - provides incentives and payment adjustments to eligible professionals who use certified EHR technology in ways that may improve healthcarestring-
Participated_in_Million_HeartsMillion Hearts is a national initiative that focuses action by communities, health systems, nonprofit organizations, federal agencies, and private-sector partners to prevent a million heart attacks and strokes by 2017. Million Hearts encourages physicians and other healthcare professionals to report—and excel in-- the Cardiovascular Prevention measures group in the PQRS program. High performance in these measures dramatically reduces the likelihood of a heart attack or strokestring-
NPIPAC_IDProfessional_Enrollment_IDLast_NameFirst_NameMiddle_NameSuffixGenderCredentialMedical_School_NameGraduation_YearPrimary_SpecialtySecondary_Specialty_1Secondary_Specialty_2Secondary_Specialty_3Secondary_Specialty_4All_Secondary_SpecialtiesOrganization_Legal_NameGroup_Practice_PAC_IDNumber_of_Group_Practice_MembersLine_1_Street_AddressLine_2_Street_AddressMarker_of_Address_Line_2_SuppressionCityStateZip_CodePhone_NumberHospital_Affiliation_CCN_1Hospital_Affiliation_LBN_1Hospital_Affiliation_CCN_2Hospital_Affiliation_LBN_2Hospital_Affiliation_CCN_3Hospital_Affiliation_LBN_3Hospital_Affiliation_CCN_4Hospital_Affiliation_LBN_4Hospital_Affiliation_CCN_5Hospital_Affiliation_LBN_5Professional_Accepts_Medicare_AssignmentParticipating_in_PQRSParticipating_in_EHRParticipated_in_Million_Hearts
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12152308594183807639I20110729000403SERRSCOTTMOTHER2010CHIROPRACTIC424 F STRUPERTID833501616Y
12351855215597714188I20050120001044TRANDECMDPMOTHER2001PODIATRY33JACKSON HEIGHTSNY113721931Y
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15482046214789737321I20120509000493EPPDAVIDMOTHER1990OPTOMETRY102 E MAIN STSAYREOK736622914Y
16897312919830269349I20080610000063TRANDUYDMOTHER1992CHIROPRACTIC32 W 6400MURRAYUT841075608M