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). 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 Medicare Physician & Other Practitioners by Provider and Service dataset provides information on use, payments, and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. 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 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. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. 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

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. 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 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.

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).

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.

Context

This dataset contains Hospital General Information from the U.S. Department of Health & Human Services. This is the BigQuery COVID-19 public dataset. This data contains a list of all hospitals that have been registered with Medicare. This list includes addresses, phone numbers, hospital types and quality of care information. The quality of care data is provided for over 4,000 Medicare-certified hospitals, including over 130 Veterans Administration (VA) medical centers, across the country. You can use this data to find hospitals and compare the quality of their care

Querying BigQuery tables

You can use the BigQuery Python client library to query tables in this dataset in Kernels. Note that methods available in Kernels are limited to querying data. Tables are at bigquery-public-data.cms_medicare.hospital_general_info.

Sample Query

How do the hospitals in Mountain View, CA compare to the average hospital in the US? With the hospital compare data you can quickly understand how hospitals in one geographic location compare to another location. In this example query we compare Google’s home in Mountain View, California, to the average hospital in the United States. You can also modify the query to learn how the hospitals in your city compare to the US national average.

“#standardSQL SELECT MTV_AVG_HOSPITAL_RATING, US_AVG_HOSPITAL_RATING FROM ( SELECT ROUND(AVG(CAST(hospital_overall_rating AS int64)),2) AS MTV_AVG_HOSPITAL_RATING FROM bigquery-public-data.cms_medicare.hospital_general_info WHERE city = 'MOUNTAIN VIEW' AND state = 'CA' AND hospital_overall_rating <> 'Not Available') MTV JOIN ( SELECT ROUND(AVG(CAST(hospital_overall_rating AS int64)),2) AS US_AVG_HOSPITAL_RATING FROM bigquery-public-data.cms_medicare.hospital_general_info WHERE hospital_overall_rating <> 'Not Available') ON 1 = 1”

What are the most common diseases treated at hospitals that do well in the category of patient readmissions? For hospitals that achieved “Above the national average” in the category of patient readmissions, it might be interesting to review the types of diagnoses that are treated at those inpatient facilities. While this query won’t provide the granular detail that went into the readmission calculation, it gives us a quick glimpse into the top disease related groups (DRG)
, or classification of inpatient stays that are found at those hospitals. By joining the general hospital information to the inpatient charge data, also provided by CMS, you could quickly identify DRGs that may warrant additional research. You can also modify the query to review the top diagnosis related groups for hospital metrics you might be interested in. “#standardSQL SELECT drg_definition, SUM(total_discharges) total_discharge_per_drg FROM bigquery-public-data.cms_medicare.hospital_general_info gi INNER JOIN bigquery-public-data.cms_medicare.inpatient_charges_2015 ic ON gi.provider_id = ic.provider_id WHERE readmission_national_comparison = 'Above the national average' GROUP BY drg_definition ORDER BY total_discharge_per_drg DESC LIMIT 10;”

The Medicare Part D Prescribers by Provider and Drug dataset provides information on prescription drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other health care providers. This dataset contains the total number of prescription fills that were dispensed and the total drug cost paid organized by prescribing National Provider Identifier (NPI), drug brand name (if applicable) and drug generic name. 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 CMS Program Statistics - Medicare Hospice tables provide use and payment data for hospice. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR HOSPICE 1. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR HOSPICE 2. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR HOSPICE 3. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Area of Residence MDCR HOSPICE 4. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Control and Type of Service Visit MDCR HOSPICE 5. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Level of Care and Site of Service MDCR HOSPICE 6. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Number of Service Visits

A list of all hospitals that have been registered with Medicare. The list includes addresses, phone numbers, hospital type, and overall hospital rating.

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 Skilled Nursing Facility tables provide use and payment data for skilled nursing facilities. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR SNF 1. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR SNF 2. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR SNF 3. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Area of Residence MDCR SNF 4. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement and Covered Days of Care MDCR SNF 5. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Facility and Bedsize MDCR SNF 6. Medicare Skilled Nursing Facilities: Distribution of Medicare Covered Skilled Nursing Facility Days, by State of Provider and Major Resource Utilization Groups (RUG)-III (versions 2013-2018 only)

The Fiscal Intermediary Shared System (FISS) Attending and Rendering dataset provides a list of those attending and rendering physicians for the FISS. FISS edits require that the Line Item Rendering Physician information be transmitted when providers submit a combined claim. Claims that include both facility and professional components, need to report the rendering physician or other practitioner at the line level if it differs from the rendering physician/practitioner reported at the claim level.

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.

All credit for variables in AHRQ_included_variables.csv is attributed to

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  Disease and Stroke Prevention, Interactive Atlas of Heart Disease and Stroke,
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  AtlasPlus. Updated 2017. https://www.cdc.gov/nchhstp/atlas/index.htm.
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  Control and Prevention (2020 and 2021 Release). Retrieved January 2022 from:
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• AHRQ SDOH Database (v1), from Centers for Disease Control and Prevention, National Center for
  Health Statistics. Multiple Cause of Death, 1999–2019, in CDC WONDER Online Database. (2021).
  Data are from the Multiple Cause of Death Files, 1999–2019, as compiled from data provided by
  the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program.
  http://wonder.cdc.gov/mcd-icd10.html.
• United States Census Bureau. Cartographic Boundary Files – Shapefile.
  https://www.census.gov/geographies/mapping-files/time-series/geo/carto-boundary-file.html.
• AHRQ SDOH Database (v1), from Robert Wood Johnson Foundation, & University of Wisconsin
  Population Health Institute. (2020). County Health Rankings & Roadmaps.
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  Collection. Retrieved September 2021, from https://ocrdata.ed.gov.
• AHRQ SDOH Database (v1), from Community Resilience Estimates Social, Economic, and
  Housing Statistics Division U.S. Census Bureau. Retrieved September 2021 from
  https://www.census.gov/programs-surveys/community-resilience-estimates.html.
• AHRQ SDOH Database (v1), from United States Environmental Protection Agency. Outdoor Air
  Quality Data. Air Quality Statistics Report. Retrieved March 2022 from:
  https://www.epa.gov/outdoor-air-quality-data/air-quality-statistics-report
• AHRQ SDOH Database (v1), from United States Environmental Protection Agency (EPA) National
  Walkability Index (2021). Retrieved June 2021 from: https://catalog.data.gov/dataset/walkabilityindex.
• AHRQ SDOH Database (v1), from U.S. Department of Agriculture, Economic Research Service.
  2010 Rural-Urban Commuting Area codes, from https://www.ers.usda.gov/data-products/ruralurban-commuting-area-codes.
• AHRQ SDOH Database (v1), from Economic Research Service (ERS), U.S. Department of
  Agriculture (USDA). Food Access Research Atlas, Retrieved November 2021 from
  https://www.ers.usda.gov/data-products/food-access-research-atlas/
• AHRQ SDOH Database (v1), from U.S. Department of Agriculture (USDA), Economic Research
  Service (ERS) 2020. Food Environment Atlas. Retrieved September 2021 from:
  https://www.ers.usda.gov/data-products/food-environment-atlas/data-access-anddocumentation-downloads/.
• AHRQ SDOH Database (v1), from LTCFocus Public Use Data sponsored by the National Institute
  on Aging (P01 AG027296) through a cooperative agreement with the Brown University School of
  Public Health. Available at www.ltcfocus.org. https://doi.org/10.26300/h9a2-2c26.
• AHRQ SDOH Database (v1), from Centers for Medicare & Medicaid Services. (n.d.). Home Health
  Compare. https://www.medicare.gov/nursinghomecompare/search.html.
• AHRQ SDOH Database (v1), from the Department of Homeland Security. Homeland Infrastructure
  Foundation-Level Data (HIFLD)—Urgent Care Facilities. 2018. Available: https://hifldgeoplatform.opendata.arcgis.com/datasets/urgent-care-facilities.
• AHRQ SDOH Database (v1), from the Indian Health Service. IHS facilities. 2021. Available:
  https://www.ihs.gov/locations/.
• AHRQ SDOH Database (v1), from the Centers for Medicare & Medicaid Services. (2020, June). MA
  State/County Penetration, from https://www.cms.gov/Research-Statistics-DataandSystems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/MA-State-CountyPenetration.
• AHRQ SDOH Database (v1), from the Centers for Medicare & Medicaid Services. (2020, June).
  Medicare Geographic Variation Public Use File, from https://www.cms.gov/Research-StatisticsData-and-Systems/Statistics-Trends-and-Reports/Medicare-Geographic-Variation/GV_PUF.
• AHRQ SDOH Database (v1), from the Centers for Disease Control and Prevention; U.S.
  Department of Health and Human Services; Agency for Toxic Substances and Disease Registry.
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  https://www.minorityhealth.hhs.gov/minority-health-svi/.
• AHRQ SDOH Database (v1), from the Centers for Medicare & Medicaid Services, Office of Minority
  Health. (2020). Medicare Mapping Disparities Tool, from https://data.cms.gov/tools/mappingmedicare-disparities-by-population.
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  Medically Underserved Areas, from https://data.hrsa.gov/data/download.
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  rural classification scheme for counties. Vital and Health Statistics. Series 2, Data Evaluation and
  Methods Research. Number 166, 1–73. https://pubmed.ncbi.nlm.nih.gov/24776070.
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  Home Compare. https://www.medicare.gov/nursinghomecompare/search.html.
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  0248.1.xml.
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  Menne, Matthew J.; Williams, Claude N., Jr.; Fenimore, Chris; Gleason, Karin; Arndt, Derek (2014):
  NOAA Monthly U.S. Climate Divisional Database (NClimDiv). NOAA National Climatic Data Center.
  doi:10.7289/V5M32STR. Retrieved from: https://www.ncei.noaa.gov/data/climdiv/access/.
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  Jang, H., &

Medical providers in the USA are identified by a sequence of numbers called the NPI, which is unique per provider. This data is publicly available from http://nppes.viva-it.com/NPI_Files.html. Under federal law (FOIA act), providers are required to release data of patient referrals from one provider to another. This data is publicly available from https://questions.cms.gov/faq.php?id=5005&faqId=7977 (Credit to Docgraph). This graph database was built in Neo4j, with data from the NPI registry (May 2014 distribution) as the set of nodes with properties, and with data from physician referrals (2012-2013 distribution) as the set of edges. The original node dataset source (May 2014 distribution): http://nppes.viva-it.com/NPI_Files.html. Data headers/documentation is included with the data. For the database, we chose to focus on only a few node attributes. These include NPI as the index, organization vs individual medical provider, practice city and state, and specialty (represented by taxonomy codes, see codebook). The original edge dataset source (2012-2014 distribution): https://questions.cms.gov/faq.php?id=5005&faqId=7977. The edge data has three columns: source of referral, destination of referral, and quantity of patients referred. Source and destination of referral are represented with NPI.

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 Order and Referring dataset provides information on all physicians and non-physician practitioners, by their National Provider Identifier (NPI), who are of a type/specialty that is legally eligible to order and refer in the Medicare program and who have current enrollment records in Medicare. 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 shows characteristics of the Inpatient Rehabilitation Facilities (IRFs) that are shown on Inpatient Rehabilitation Facility Compare. It includes a list of IRFs with information such as address, phone number, state, city and county data with the information about Centers for Medicare & Medicaid Services (CMS) Regions where each of the IRFs are located. This dataset also contains data regarding different measure codes and their corresponding scores for majority of the IRFs.

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. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. 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