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 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 Unique Physician Identification Number (UPIN) Directory contains selected information on physicians, doctors of Osteopathy, limited licensed practitioners and some non-physician practitioners who are enrolled in the Medicare Program.

The data elements in the file (UPIN, full name, specialty, Physician License State Code, zip code, Medicare provider billing number and State) are extracted from the UPIN Database and are approved for public release in the Centers for Medicare and Medicaid Services (CMS) System of Records.

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?

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.

This data package shows information on Medicare enrollment level data for providers organized at the individual level, Phase III target list which revalidates all remaining providers, a list of due dates by which the provider/supplier's revalidation application must reach their MAC (Medicare Administrative Contractor) and the number of Medicare beneficiaries who use a health service area and a list of all providers and suppliers who have been mailed a revalidation notice.

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.

This look-up tool is a searchable database that allows you to look up a provider by National Provider Identifier (NPI), or by name and location. The look-up tool will return information on services and procedures provided to Medicare beneficiaries, including utilization information, payment amounts (allowed amount and Medicare payment), and submitted charges organized by Healthcare Common Procedure Coding System (HCPCS) code. The data covers calendar year 2016 and contains 100 percent final-action physician supplier Part B non-institutional line items for the Medicare fee-for- service population (information is redacted where necessary to protect beneficiary privacy).

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 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.

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.

This data package contains the Physician Quality Reporting System (PQRS), Performance Rates for Individual Eligible Professionals (EP) PQRS, Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Group Practice.

This dataset conisists of a list of due dates by which the provider/supplier's revalidation application must reach their MAC (Medicare Administrative Contractor) in order for them to remain in compliance with Medicare's provider enrollment requirements.

This series of files links two large population-based sources providing detailed data about Medicare beneficiaries with cancer. The SEER (Surveillance, Epidemiology, and End Results) program consists of clinical, demographic, and cause of death information collected from tumor registries beginning in January 1, 1973. The Medicare contribution includes all claims for covered health care services from beneficiaries’ time of eligibility until death. Linkage is processed biennially by SEER and Centers for Medicare and Medicaid Services (CMS) staff. 95% of individuals age 65 and older are included in the SEER files. Due to privacy concerns, access to this database requires an application, SEER-Medicare Data Use Agreement (DUA), and documentation of institutional review board approval. Additionally, the National Cancer Institute’s information technology contractor assesses a processing fee the amount of which is dependent upon the type and number of files requested.

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.

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.

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 Nuclear Medicine National HQ System database is a series of MS Excel spreadsheets and Access Database Tables by fiscal year. They consist of information from all Veterans Affairs Medical Centers (VAMCs) performing or contracting nuclear medicine services in Veterans Affairs medical facilities. The medical centers are required to complete questionnaires annually (RCS 10-0010-Nuclear Medicine Service Annual Report). The information is then manually entered into the Access Tables, which includes: * Distribution and cost of in-house VA - Contract Physician Services, whether contracted services are made via sharing agreement (with another VA medical facility or other government medical providers) or with private providers. * Workload data for the performance and/or purchase of PET/CT studies. * Organizational structure of services. * Updated changes in key imaging service personnel (chiefs, chief technicians, radiation safety officers). * Workload data on the number and type of studies (scans) performed, including Medicare Relative Value Units (RVUs), also referred to as Weighted Work Units (WWUs). WWUs are a workload measure calculated as the product of a study's Current Procedural Terminology (CPT) code, which consists of total work costs (the cost of physician medical expertise and time), and total practice costs (the costs of running a practice, such as equipment, supplies, salaries, utilities etc). Medicare combines WWUs together with one other parameter to derive RVUs, a workload measure widely used in the health care industry. WWUs allow Nuclear Medicine to account for the complexity of each study in assessing workload, that some studies are more time consuming and require higher levels of expertise. This gives a more accurate picture of workload; productivity etc than using just 'total studies' would yield. * A detailed Full-Time Equivalent Employee (FTEE) grid, and staffing distributions of FTEEs across nuclear medicine services. * Information on Radiation Safety Committees and Radiation Safety Officers (RSOs). Beginning in 2011 this will include data collection on part-time and non VA (contract) RSOs; other affiliations they may have and if so to whom they report (supervision) at their VA medical center.Collection of data on nuclear medicine services' progress in meeting the special needs of our female veterans. Revolving documentation of all major VA-owned gamma cameras (by type) and computer systems, their specifications and ages. * Revolving data collection for PET/CT cameras owned or leased by VA; and the numbers and types of PET/CT studies performed on VA patients whether produced on-site, via mobile PET/CT contract or from non-VA providers in the community.* Types of educational training/certification programs available at VA sites * Ongoing funded research projects by Nuclear Medicine (NM) staff, identified by source of funding and research purpose. * Data on physician-specific quality indicators at each nuclear medicine service.* Academic achievements by NM staff, including published books/chapters, journals and abstracts. * Information from polling field sites re: relevant issues and programs Headquarters needs to address. * Results of a Congressionally mandated contracted quality assessment exercise, also known as a Proficiency study. Study results are analyzed for comparison within VA facilities (for example by mission or size), and against participating private sector health care groups. * Information collected on current issues in nuclear medicine as they arise. Radiation Safety Committee structures and membership, Radiation Safety Officer information and information on how nuclear medicine services provided for female Veterans are examples of current issues.The database is now stored completely within MS Access Database Tables with output still presented in the form of Excel graphs and tables.

description:

This look-up tool is a searchable database that allows you to look up a Medicare Part D prescriber by National Provider Identifier (NPI), or by name and location. The look-up tool will return information on prescriptions provided to and filled by Medicare beneficiaries, including drug name, total number of prescriptions dispensed (including original prescriptions and refills) and total drug cost. The data covers calendar year 2013 and is based on final-action Part D claims for the entire Medicare Part D population. Information is redacted where necessary to protect beneficiary privacy.

The database is populated from the Medicare Part D Prescriber Public Use File (PUF). Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D claims, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physicians entire practice as it only includes information on beneficiaries enrolled in Medicare Part D prescription drug program. In addition, the data are not intended to indicate the quality of care provided. To review more information about the Part D Prescriber PUF, please refer to the Methodology document.

This look-up tool is a searchable database that allows you to look up a Medicare Part D prescriber by National Provider Identifier (NPI), or by name and location. The look-up tool will return information on prescriptions provided to and filled by Medicare beneficiaries, including drug name, total number of prescriptions dispensed (including original prescriptions and refills) and total drug cost. The data covers calendar year 2013 and is based on final-action Part D claims for the entire Medicare Part D population. Information is redacted where necessary to protect beneficiary privacy.

The database is populated from the Medicare Part D Prescriber Public Use File (PUF). Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D claims, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physicians entire practice as it only includes information on beneficiaries enrolled in Medicare Part D prescription drug program. In addition, the data are not intended to indicate the quality of care provided. To review more information about the Part D Prescriber PUF, please refer to the Methodology document.

We are releasing data that compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of May 15, 2020. This data is already available on other websites, but this chart brings the information together into one view for comparison. You can find additional information on the Accelerated and Advance Payments at the following links:

Fact Sheet: https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf;

Zip file on providers in each state: https://www.cms.gov/files/zip/accelerated-payment-provider-details-state.zip

Medicare Accelerated and Advance Payments State-by-State information and by Provider Type: https://www.cms.gov/files/document/covid-accelerated-and-advance-payments-state.pdf.

This file was assembled by HHS via CMS, HRSA and reviewed by leadership and compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of December 4, 2020.

HHS Provider Relief Fund President Trump is providing support to healthcare providers fighting the coronavirus disease 2019 (COVID-19) pandemic through the bipartisan Coronavirus Aid, Relief, & Economic Security Act and the Paycheck Protection Program and Health Care Enhancement Act, which provide a total of $175 billion for relief funds to hospitals and other healthcare providers on the front lines of the COVID-19 response. This funding supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures uninsured Americans can get treatment for COVID-19. HHS is distributing this Provider Relief Fund money and these payments do not need to be repaid. The Department allocated $50 billion of the Provider Relief Fund for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers' net reimbursement. It allocated another $22 billion to providers in areas particularly impacted by the COVID-19 outbreak, rural providers, and providers who serve low-income populations and uninsured Americans. HHS will be allocating the remaining funds in the near future.

As part of the Provider Relief Fund distribution, all providers have 45 days to attest that they meet certain criteria to keep the funding they received, including public disclosure. As of May 15, 2020, there has been a total of $34 billion in attested payments. The chart only includes those providers that have attested to the payments by that date. We will continue to update this information and add the additional providers and payments once their attestation is complete.

CMS Accelerated and Advance Payments Program On March 28, 2020, to increase cash flow to providers of services and suppliers impacted by the coronavirus disease 2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) expanded the Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. Beginning on April 26, 2020, CMS stopped accepting new applications for the Advance Payment Program, and CMS began reevaluating all pending and new applications for Accelerated Payments in light of the availability of direct payments made through HHS’s Provider Relief Fund.

Since expanding the AAP program on March 28, 2020, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, which includes hospitals, through May 18, 2020. For Part B suppliers—including doctors, non-physician practitioners and durable medical equipment suppliers— during the same time period, CMS approved almost 24,000 applications advancing $40.4 billion in payments. The AAP program is not a grant, and providers and suppliers are required to repay the loan.

CMS has published AAP data, as required by the Continuing Appropriations and Other Extensions Act of 2021, on this website: https://www.cms.gov/files/document/covid-medicare-accelerated-and-advance-payments-program-covid-19-public-health-emergency-payment.pdf. Requests for additional data related to the program must be submitted through the CMS FOIA office. For more information on how to submit a FOIA request please visit our website at https://www.cms.gov/Regulations-and-Guidance/Legislation/FOIA. The PRF is administered by the Health Resources & Services Administration (HRSA). For more information on how to submit a request for unpublished program data from HRSA, please visit https://www.hrsa.gov/foia/index.html.

Provider Relief Fund Data - https://data.cdc.gov/Administrative/Provider-Relief-Fund-COVID-19-High-Impact-Payments/b58h-s9zx

The Hospital Service Area data is a summary of calendar year Medicare inpatient hospital fee-for-service and Medicare Advantage claims data. It contains number of discharges, total days of care, and total charges summarized by hospital provider number and the ZIP code of the Medicare beneficiary.

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.

HHS is providing support to healthcare providers fighting the coronavirus disease 2019 (COVID-19) pandemic through the bipartisan Coronavirus Aid, Relief, & Economic Security (CARES) Act; the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA); and the Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act, which provide a total of $178 billion for relief funds to hospitals and other healthcare providers on the front lines of the COVID-19 response. This funding supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures uninsured Americans can get treatment for COVID-19. HHS is distributing this Provider Relief Fund (PRF) money and these payments do not need to be repaid.

The Department allocated $50 billion in PRF payments for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers' net reimbursement. HHS has made other PRF distributions to a wide array of health care providers and more information on those distributions can be found here: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/data/index.html