The Medicare Physician & Other Practitioners by Provider dataset provides information on use, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI).

The CMS Program Statistics - Medicare Providers summary tables provide data on institutional (i.e., hospitals, skilled nursing facilities, home health agencies, hospices, etc.) and non-institutional (i.e., physicians, nonphysicians, specialists, and suppliers) providers. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR PROVIDERS 1. Medicare Providers: Number of Medicare Certified Institutional Providers, Yearly Trend MDCR PROVIDERS 2. Medicare Providers: Number of Medicare Certified Inpatient Hospital and Skilled Nursing Facility Beds and Beds Per 1,000 Enrollees, Yearly Trend MDCR PROVIDERS 3. Medicare Providers: Number of Medicare Certified Facilities, by Type of Control, Yearly Trend MDCR PROVIDERS 4. Medicare Providers: Number of Skilled Nursing Facilities and Medicare Certified Hospitals, and Number of Beds, by State, Territories, Possessions and Other Areas MDCR PROVIDERS 5. Medicare Providers: Number of Medicare Certified Providers, by Type of Provider, by State, Territories, Possessions, and Other Areas MDCR PROVIDERS 6. Medicare Providers: Number of Medicare Non-Institutional Providers by Specialty, Yearly Trend MDCR PROVIDERS 7. Medicare Providers: Number of Medicare Non-Institutional Providers, by State, Territories, Possessions, and Other Areas, Yearly Trend

Verify the accuracy of SSNs of all individual Medicare providers, owners, managing/directing employees, authorized representatives, ambulance service medical directors, ambulance crew members, technicians, chain organization administrators, Independent Diagnostic Test Facility (IDTF), supervising/directing physicians, and IDTF interpretation service providers. Also included in this Agreement are individual health care providers who apply for a National Provider Identification Number (NPI).

Content

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This dataset will no longer be updated effective 2/25/2019

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

Cover photo by rawpixel on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

This dataset is distributed under NA

Please be advised that as of Q4 2023 there is a new Provider of Service file (POS) that contains the provider and certification details for Home Health Agencies (HHAs), Hospices, and Ambulatory Surgical Centers (ASCs). Data contained in this file are extracted from the Internet Quality Improvement and Evaluation System (iQIES) environment and will be updated quarterly along with the other two POS files. The Provider of Services File - Hospital & Non-Hospital Facilities data provide critical resources for other federal regulator requirements as well as supports the ongoing quality & research efforts sponsored by CMS. In this file you will find provider certification, termination, accreditation, ownership, name, location and other characteristics organized by CMS Certification Number.

This is a random sampling of the 2022 public data set hosted by the Center for Medicare & Medicaid Services at:

https://data.cms.gov/provider-summary-by-type-of-service/medicare-physician-other-practitioners/medicare-physician-other-practitioners-by-provider-and-service

The complete data set for 2022 can be found there. This random sampling has 292,663 rows and 29 columns. The full set hosted at the link above is about 3GB in size with 9,755,427 rows and 29 columns. The 29 columns are:

1. National Provider Identifier (Rndrng_NPI)
2. Last Name/Organization Name of the Provider (Rndrng_Prvdr_Last_Org_Name)
3. First Name of the Provider (Rndrng_Prvdr_First_Name)
4. Middle Initial of the Provider (Rndrng_Prvdr_MI)
5. Credentials of the Provider (Rndrng_Prvdr_Crdntls)
6. Gender of the Provider (Rndrng_Prvdr_Gndr)
7. Entity Type of the Provider (Rndrng_Prvdr_Ent_Cd)
8. Street Address 1 of the Provider (Rndrng_Prvdr_St1)
9. Street Address 2 of the Provider (Rndrng_Prvdr_St2)
10. City of the Provider (Rndrng_Prvdr_City)
11. State Abbreviation of the Provider (Rndrng_Prvdr_State_Abrvtn)
12. State FIPS Code of the Provider (Rndrng_Prvdr_State_FIPS)
13. Zip Code of the Provide (Rndrng_Prvdr_Zip5)
14. RUCA Code of the Provider (Rndrng_Prvdr_RUCA)
15. RUCA Description (Rndrng_Prvdr_RUCA_Desc)
16. Country Code of the Provider (Rndrng_Prvdr_Cntry)
17. Provider Type of the Provider (Rndrng_Prvdr_Type)
18. Medicare Participation Indicator (Rndrng_Prvdr_Mdcr_Prtcptg_Ind)
19. HCPCS Code (HCPCS_Cd)
20. HCPCS Description (HCPCS_Desc)
21. HCPCS Drug Indicator (HCPCS_Drug_Ind)
22. Place of Service (Place_Of_Srvc)
23. Number of Medicare Beneficiaries (Tot_Benes)
24. Number of Services (Tot_Srvcs)
25. Number of Distinct Medicare Beneficiary/Per Day Services (Tot_Bene_Day_Srvcs)
26. Average Submitted Charge Amount (Avg_Sbmtd_Chrg)
27. Average Medicare Allowed Amount (Avg_Mdcr_Alowd_Amt)
28. Average Medicare Payment Amount (Avg_Mdcr_Pymt_Amt)
29. Average Medicare Standardized Payment Amount (Avg_Mdcr_Stdzd_Amt)

A brief description of each these columns can be found here:

https://data.cms.gov/resources/medicare-physician-other-practitioners-by-provider-and-service-data-dictionary

A full description of the data is in the 27-page document, "Medicare Fee-For-Service Provider Utilization & Payment Data Physician and Other Supplier Public Use File: A Methodological Overview" which can be found here:

www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-provider-charge-data/downloads/medicare-physician-and-other-supplier-puf-methodology.pdf

This data set is similar to the one posted by Tamil Selvan here https://www.kaggle.com/datasets/tamilsel/healthcare-providers-data. That data's origin is unclear, however it is very likely from same source. It has different header text and may be from one of the earlier years.

The Revalidation Due Date List dataset contains revalidation due dates for Medicare providers who are due to revalidate in the following six months. If a provider's due date does not fall within the ensuing six months, the due date is marked 'TBD'. In addition the dataset also includes subfiles with reassignment information for a given provider as well as due date listings for clinics and group practices and their providers. Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

The Revalidation Reassignment List dataset provides information on reassignments of providers who are due for revalidation. Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.This dataset is based on information gathered from the Provider Enrollment, Chain and Ownership System (PECOS).

The Medicare Fee-For-Service Public Provider Enrollment dataset includes information on providers who are actively approved to bill Medicare or have completed the 855O at the time the data was pulled from the Provider Enrollment, Chain, and 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.

This dataset includes a list of hospice agencies with data on the quality of patient care measures shown on Hospice Compare. It includes information about hospice agencies such as address, phone number, ownership data and different Centers for Medicare & Medicaid Services (CMS) Regions they belong to. This dataset also contains data regarding the corresponding scores against each of the measures for quality of patient care.

The Physician Compare website was created by the Centers for Medicare & Medicaid Services (CMS) in December 2010 as required by the Affordable Care Act (ACA) of 2010 to help patients assess and find doctors and hospitals. This dataset contains the information supplied to patients via that website, including patient satisfaction surveys and performance scores across over 100 metrics.

Acknowledgements

This dataset was kindly released by the Centers for Medicare & Medicaid Services. You can find the original copy of the dataset here.

The CMS Program Statistics - Medicare Advantage & Other Health Plan Enrollment tables provide data on characteristics of the population covered by Medicare Advantage & other health plans.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR ENROLL AB 15. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend
MDCR ENROLL AB 16. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend
MDCR ENROLL AB 17. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics
MDCR ENROLL AB 18. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics
MDCR ENROLL AB 19. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence
MDCR ENROLL AB 20. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence

Variability in mean payment per physician, number of physicians, and aggregated payments for transactions in the Open Payments database, 2014–2018, for each top-category specialty available for allopathic and osteopathic physicians.

The CMS Program Statistics - Medicare Physician, Non-Physician Practitioner and Supplier tables provide use and payment data for physicians, other practitioners, limited-licensed practitioners, and durable medical equipment, prosthetic, and orthotic (DMEPOS) suppliers. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR PHYSSUPP 1. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR PHYSSUPP 2. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR PHYSSUPP 3. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Area of Residence MDCR PHYSSUPP 4. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Type of Service MDCR PHYSSUPP 5. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Place of Service MDCR PHYSSUPP 6. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Physician Specialty MDCR PHYSSUPP 7. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization and Program Payments for Original Medicare Beneficiaries, by Berenson-Eggers Type of Service (BETOS) Classification

Content

Database of HPSA and Low-Income ZIP Codes for Issuers Subject to the Alternate ECP Standard for the purposes of QHP Certification

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

Cover photo by Markus Spiske on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

This dataset is distributed under NA

ECP Rolling Draft Dataset. Please visit https://data.healthcare.gov/rolling-draft-list to search and filter for your provider site within the Rolling Draft Essential Community Provider (ECP) List.

The PROVIDER table contains a list of uniquely identified healthcare providers. These are individuals providing hands-on healthcare to patients, such as physicians, nurses, midwives, physical therapists etc.

This Dataset was derived from CMS's database. This is PUBLIC information and I do not OWN this data at all. This dataset was added to Kaggle due to discrepancies in downloading the original .csv provided on the website. Please refer to CMS's primary database for more information regarding this data. Thank you.

Unplanned Hospital Visits: provider data. This data set includes provider data for the hospital return days (or excess days in acute care [EDAC]) measures, the unplanned readmissions measures, and measures of unplanned hospital visits after outpatient procedures. NOTICE: Data from the 1st and 2nd quarters of 2020 are not being reported due to the impact of the COVID-19 pandemic. For more information, please reference https://qualitynet.cms.gov/files/5fb838aef61c410025a64709?filename=2020-111-IP.pdf.

The purpose of the project is to detect unreported Supplemental Security Income (SSI) recipient admissions to Title XIX institutions. A file containing SSN's of SSI recipients (all eligible individuals and members of eligible couples in current pay) will be matched against the Health Care Financing Administration's (HCFA) Minimum Data Set (MDS) database which contains admission, discharge, re-entry and assessment information about persons in Title XIX facilities for all 50 States and Washington, D.C. This database is updated monthly. The match will produce an output file containing MDS data pertinent to SSI eligibility on matched records. This data will be compared back to the SSR data to generate alerts to the Field Offices for their actions.

This data set contains a list of hospice agencies with data on their scores on the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey measures.