Context

The CMS National Plan and Provider Enumeration System (NPPES) was developed as part of the Administrative Simplification provisions in the original HIPAA act. The primary purpose of NPPES was to develop a unique identifier for each physician that billed medicare and medicaid. This identifier is now known as the National Provider Identifier Standard (NPI) which is a required 10 digit number that is unique to an individual provider at the national level.

Once an NPI record is assigned to a healthcare provider, parts of the NPI record that have public relevance, including the provider’s name, speciality, and practice address are published in a searchable website as well as downloadable file of zipped data containing all of the FOIA disclosable health care provider data in NPPES and a separate PDF file of code values which documents and lists the descriptions for all of the codes found in the data file.

Content

The dataset contains the latest NPI downloadable file in an easy to query BigQuery table, npi_raw. In addition, there is a second table, npi_optimized which harnesses the power of Big Query’s next-generation columnar storage format to provide an analytical view of the NPI data containing description fields for the codes based on the mappings in Data Dissemination Public File - Code Values documentation as well as external lookups to the healthcare provider taxonomy codes . While this generates hundreds of columns, BigQuery makes it possible to process all this data effectively and have a convenient single lookup table for all provider information.

Fork this kernel to get started.

Acknowledgements

https://bigquery.cloud.google.com/dataset/bigquery-public-data:nppes?_ga=2.117120578.-577194880.1523455401

https://console.cloud.google.com/marketplace/details/hhs/nppes?filter=category:science-research

Dataset Source: Center for Medicare and Medicaid Services. This dataset is publicly available for anyone to use under the following terms provided by the Dataset Source - http://www.data.gov/privacy-policy#data_policy — and is provided "AS IS" without any warranty, express or implied, from Google. Google disclaims all liability for any damages, direct or indirect, resulting from the use of the dataset.

Banner Photo by @rawpixel from Unplash.

Inspiration

What are the top ten most common types of physicians in Mountain View?

What are the names and phone numbers of dentists in California who studied public health?

NCHS has linked data from various surveys with Medicare program enrollment and health care utilization and expenditure data from the Centers for Medicare & Medicaid Services (CMS). Linkage of the NCHS survey participants with the CMS Medicare data provides the opportunity to study changes in health status, health care utilization and costs, and prescription drug use among Medicare enrollees. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

Medicare is a federal health insurance program for those aged 65 and older, certain people under 65 with disabilities, and people of any age with end-stage renal disease in the United States (US). Medicare covers about 96% of all US citizens aged 65 and older. These data have been used to describe patterns of morbidity and mortality and burden of disease, compare the effectiveness of pharmacologic therapies, examine the cost of care, evaluate the effects of provider practices on the delivery of care, and explore the effects of important policy changes on physician practices and patient outcomes. In 2014, 16% of Medicare beneficiaries were under the age of 65 years, 46% were between 65 and 74 years, 25% between 75 and 84 years, and 12% over the age of 85 years. Fifty-five percent of beneficiaries were female, 76% were white, 10% black, 9% Hispanic, and 5% Asian or other/unknown race.

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarizes the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals. The dataset includes the following data - common inpatient and outpatient services from 2012 to 2015.

Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount that providers bill for an item, service, or procedure.

This data set accompanies the Profile of the California Medicare Population chartbook, published by the Office of Medicare Innovation and Integration in February 2022, and available at (https://www.dhcs.ca.gov/services/Documents/OMII-Medicare-Databook-February-18-2022.pdf). The three data files in this data set were analyzed from federal administrative data (the Medicare Master Beneficiary Summary File) for beneficiary characteristics as of March 2021. These datasets include: Medicare enrollment, Medicare Advantage enrollment (and its converse fee-for-service Medicare enrollment), dual Medi-Cal eligibility and enrollment (and its converse Medicare-only enrollment), by county. Medicare Savings Program enrollees were considered Medicare-only and not dually enrolled in Medi-Cal. All Medicare Part C beneficiaries, including PACE, Cal MediConnect and Special Needs Plans, were considered to have Medicare Advantage.

DHCS partnered with The SCAN Foundation and ATI Advisory in 2021 and 2022 to develop a series of chartbooks that provide information about Medicare beneficiaries in California. This work is supported by a grant from The SCAN Foundation to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.

The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and March 31, 2025. The data were used to generate the Medicare Telehealth Trends Report.

NCHS has linked data from various surveys with 1999-2013 Medicare program enrollment and health care utilization and expenditure data from the Centers for Medicare & Medicaid Services (CMS). Linkage of the NCHS survey participants with the CMS Medicare data provides the opportunity to study changes in health status, health care utilization and costs, and prescription drug use among Medicare enrollees. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

Data consist of CMS Medicare data files which are restricted access and cannot be released publicly. This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. EPA cannot release CBI, or data protected by copyright, patent, or otherwise subject to trade secret restrictions. Request for access to CBI data may be directed to the dataset owner by an authorized person by contacting the party listed. It can be accessed through the following means: CMS Medicare data are available from: https://www.cms.gov/data-research/files-for-order/data-disclosures-and-data-use-agreements-duas/limited-data-set-lds with the requirement of a signed Data Use Agreement. . Weather data are available at https://prism.oregonstate.edu/. Format: The data that support the findings of this study are available from the Centers for Medicare and Medicaid Services (CMS). Restrictions apply to the availability of these data, which were provided under a Data Use Agreement specific to this study. Data are available from: https://www.cms.gov/data-research/files-for-order/data-disclosures-and-data-use-agreements-duas/limited-data-set-lds with the requirement of a signed Data Use Agreement. Data do not contain personally identifiable information but contain are classified as Limited Data Set files and their distribution require an agreement and between CMS and the requester and approval by CMS. Weather data are available at https://prism.oregonstate.edu/. Because the data do not contain identifiable private information and were not obtained through interaction or intervention with individuals, the Institutional Review Board for the University of North Carolina and the US Environmental Protection Agency Human Research Protocol Officer determined that use of this data does not constitute human subjects research. This dataset is associated with the following publication: Wade, T., and C. Herbert. Weather conditions and legionellosis: a nationwide case-crossover study among Medicare recipients. EPIDEMIOLOGY AND INFECTION. Cambridge University Press, Cambridge, UK, 152: E125, (2024).

Content

The following dataset demonstrates the Medicare-enrolled MDPP suppliers from which eligible Medicare beneficiaries may be furnished MDPP services. If you receive your Medicare coverage via a Medicare Advantage plan, please consult your health plan to identify the specific MDPP suppliers that are available to you with no cost sharing

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 Philipp Mandler on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

The datasets include the monthly count of individuals who are enrolled in Medicare Savings Programs (MSP), by aid code and county. The counts reflect the total number of eligible individuals enrolled during the month. MSP help individuals with limited income and resources pay for some of the out-of-pocket costs for Medicare, including Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance. There are four Medicare Savings Programs: Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Working Disabled Individual (QWDI). Individuals who are eligible for QMB, SLMB, and QI also automatically qualify for the Low Income Subsidy (or “Extra Help”) program, which helps lower the cost of prescription drugs. Counties and aid codes with zero individuals enrolled during a reporting period are not included in the dataset.

2014-2019. This dataset is a de-identified summary table of vision and eye health data indicators from Medicare claims, stratified by all available combinations of age group, race/ethnicity, gender, and state. Medicare claims for VEHSS includes beneficiaries who were fully enrolled in Medicare Part B Fee-for-Service (FFS) for the duration of the year. Medicare claims provide a convenience sample that includes approximately 30 million individuals annually, which represents nearly 89% of the US population aged 65 and older and 3.3% of the US population younger than 65, including persons disabled due to blindness. Medicare data for VEHSS include Service Utilization and Medical Diagnoses indicators. Data were suppressed for de-identification to ensure protection of patient privacy. Data will be updated as it becomes available. Detailed information on VEHSS Medicare analyses can be found on the VEHSS Medicare webpage (cdc.gov/visionhealth/vehss/data/claims/medicare.html). Information on available Medicare claims data can be found on the ResDac website (www.resdac.org). The VEHSS Medicare dataset was last updated May 2023.

Content

This crosswalk links the types of providers and suppliers who are eligible to apply for enrollment in the Medicare program with the appropriate Healthcare Provider Taxonomy Codes. This crosswalk includes the Medicare Specialty Codes for those provider/supplier types who have Medicare Specialty Codes. The Healthcare Provider Taxonomy Code Set is available from the Washington Publishing Company (www.wpc-edi.com) and is maintained by the National Uniform Claim Committee (www.nucc.org). The code set is updated twice a year, with the updates being effective April 1 and October 1 of each year. This document reflects Healthcare Provider Taxonomy Codes effective for use on April 2, 2018.

When changes are made to Medicare provider enrollment requirements, the Medicare Specialty Codes, or the Healthcare Provider Taxonomy Code Set, this document may need to be revised.

NOTE: This document does not alter existing Medicare claims preparation, processing, or payment instructions, nor does it alter existing Medicare provider enrollment requirements or policies.

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

Content

The Affordable Care Act created the new Pre-Existing Condition Insurance Plan (PCIP) program to make health insurance available to Americans denied coverage by private insurance companies because of a pre-existing condition. Coverage for people living with such conditions as diabetes, asthma, cancer, and HIV/AIDS has often been priced out of the reach of most Americans who buy their own insurance, and this has resulted in a lack of coverage for millions. The temporary program covers a broad range of health benefits and is designed as a bridge for people with pre-existing conditions who cannot obtain health insurance coverage in today’s private insurance market. To learn more, visit PCIP.gov or HealthCare.gov.

Note: * Massachusetts and Vermont are guarantee issue states that have already implemented many of the broader market reforms included in the Affordable Care Act that take effect in 2014. Existing commercial plans offering guaranteed coverage at premiums comparable to PCIP are already available in both states.

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 Lily Banse on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

Hospitals Registered with MedicareThis feature layer, utilizing data from the Centers of Medicare and Medicaid Services (CMS), depicts all hospitals that are currently registered with Medicare in the U.S. Per NIH, "Since the passage of Medicare legislation in 1965, Section 1861 of the Social Security Act has stated that hospitals participating in Medicare must meet certain requirements specified in the act and that the Secretary of the Department of Health, Education and Welfare (HEW) [now the Department of Health and Human Services (DHHS)] may impose additional requirements found necessary to ensure the health and safety of Medicare beneficiaries receiving services in hospitals. On this basis, the Conditions of Participation, a set of regulations setting minimum health and safety standards for hospitals participating in Medicare, were promulgated in 1966 and substantially revised in 1986."Ascension Columbia St Mary's HospitalData currency: 11/26/2024Data modification: This data was created using the geocoding process on the CSV file.Data downloaded from: Hospital General InformationFor more information: HospitalsSupport documentation: Data dictionaryFor feedback, please contact: ArcGIScomNationalMaps@esri.comCenters of Medicare and Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

Context

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarize counts of enrollees who are dually-eligible for both Medicare and Medicaid program, including those in Medicare Savings Programs. “Duals” represent 20 percent of all Medicare beneficiaries, yet they account for 34 percent of all spending by the program, according to the Commonwealth Fund . As a representation of this high-needs, high-cost population, these data offer a view of regions ripe for more intensive care coordination that can address complex social and clinical needs. In addition to the high cost savings opportunity to deliver upstream clinical interventions, this population represents the county-by-county volume of patients who are eligible for both state level (Medicaid) and federal level (Medicare) reimbursements and potential funding streams to address unmet social needs across various programs, waivers, and other projects. The dataset includes eligibility type and enrollment by quarter, at both the state and county level. These data represent monthly snapshots submitted by states to the CMS, which are inherently lower than ever-enrolled counts (which include persons enrolled at any time during a calendar year.) For more information on dually eligible beneficiaries

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.sdoh_cms_dual_eligible_enrollment.

Sample Query

In what counties in Michigan has the number of dual-eligible individuals increased the most from 2015 to 2018? Find the counties in Michigan which have experienced the largest increase of dual enrollment households

duals_Jan_2015 AS ( SELECT Public_Total AS duals_2015, County_Name, FIPS FROM bigquery-public-data.sdoh_cms_dual_eligible_enrollment.dual_eligible_enrollment_by_county_and_program WHERE State_Abbr = "MI" AND Date = '2015-12-01' ),

duals_increase AS ( SELECT d18.FIPS, d18.County_Name, d15.duals_2015, d18.duals_2018, (d18.duals_2018 - d15.duals_2015) AS total_duals_diff FROM duals_Jan_2018 d18 JOIN duals_Jan_2015 d15 ON d18.FIPS = d15.FIPS )

SELECT * FROM duals_increase WHERE total_duals_diff IS NOT NULL ORDER BY total_duals_diff DESC

Abstract

The MarketScan Medicare Supplemental Database provides detailed cost, use and outcomes data for healthcare services performed in both inpatient and outpatient settings.

It Include Medicare Supplemental records for all years, and Medicare Advantage records starting in 2020. This page also contains the MarketScan Medicare Lab Database starting in 2018.

Starting in 2026, there will be a data access fee for using the full dataset. Please refer to the 'Usage Notes' section of this page for more information.

Methodology

MarketScan Research Databases are a family of data sets that fully integrate many types of data for healthcare research, including:

• De-identified records of more than 250 million patients (medical, drug and dental)

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• Laboratory results

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• Hospital discharges

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The MarketScan Databases track millions of patients throughout the healthcare system. The data are contributed by large employers, managed care organizations, hospitals, EMR providers and Medicare.

Usage

This page contains the MarketScan Medicare Database.

We also have the following on other pages:

• The MarketScan Commercial Database
• The MarketScan Dental Database
• The MarketScan Benefit Plan Design data
• MarketScan Redbook (The MarketScan Code Reference Book)

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**Starting in 2026, there will be a data access fee for using the full dataset **

(though the 1% sample will remain free to use). The pricing structure and other

**relevant information can be found in this **FAQ Sheet.

Before Manuscript Submission

All manuscripts (and other items you'd like to publish) must be submitted to

support@stanfordphs.freshdesk.com for approval prior to journal submission.

We will check your cell sizes and citations.

For more information about how to cite PHS and PHS datasets, please visit:

https:/phsdocs.developerhub.io/need-help/citing-phs-data-core

Data Documentation

Data access is required to view this section.

Section 2

Metadata access is required to view this section.

Section 3

Metadata access is required to view this section.

The dataset contains information about the prevalence of chronic conditions among Original Medicare beneficiaries as well as about the spending and co-occurring conditions for those with each condition. The data are available for California and for the rest of the United States, overall and by demographic and geographic groups. Additionally, the data are available for each of 19 California geographic regions overall and by demographic and geographic groups. The data represent Medicare beneficiaries who are in the Original Medicare program. Medicare offers health care coverage for older adults and certain individuals with disabilities. The Original Medicare program is Parts A and B of Medicare, administered by the U.S. Centers for Medicare & Medicaid Services. The analysis excludes enrollees of the Medicare Advantage program, administered by private insurers, because Medicare Advantage data are incomplete.

Data from: https://data.medicare.gov/Hospital-Compare/Payment-and-value-of-care-Hospital/c7us-v4mf More information coming soon!

Context

There's a story behind every dataset and here's your opportunity to share yours.

Content

What's inside is more than just rows and columns. Make it easy for others to get started by describing how you acquired the data and what time period it represents, too.

Acknowledgements

We wouldn't be here without the help of others. If you owe any attributions or thanks, include them here along with any citations of past research.

Inspiration

Your data will be in front of the world's largest data science community. What questions do you want to see answered?

This dataset tracks the updates made on the dataset "Eligible Individuals Enrolled in Medicare Savings Programs (MSP)" as a repository for previous versions of the data and metadata.

Content

More details about each file are in the individual file descriptions.

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.

This dataset is distributed under the following licenses: NA