What is NPI Data? Definition, Examples & Uses

What are Examples of NPI Data?

Examples of NPI data include the provider’s NPI number, full name, specialty, practice address, phone number, and taxonomy codes. This information helps healthcare organizations verify provider credentials, manage provider directories, and ensure accurate billing and reimbursement processes.

NPI Data Attributes

• NPI Number: A unique 10-digit identifier assigned to each healthcare provider.
• Provider Name: The full name of the individual or organization associated with the NPI.
• Specialty: The specific medical or healthcare specialty of the provider.
• Practice Location: Address and contact information for the provider’s practice.
• Taxonomy Codes: Codes that classify the provider’s healthcare role or specialty.

How is NPI Data Collected?

NPI data is collected and maintained by the Centers for Medicare & Medicaid Services (CMS) as part of the National Plan and Provider Enumeration System (NPPES). Providers are required to apply for an NPI and keep their information updated regularly. This data is publicly accessible through the NPPES NPI Registry, allowing healthcare organizations, insurance companies, and other entities to verify provider information.

Why is NPI Data Important?

NPI data is essential because it provides a standardized method to identify and verify healthcare providers across the United States. Utilizing NPI data ensures that providers are accurately credentialed and maintain reliable provider directories.

NPI Data Use Cases

• Healthcare Research: Supporting healthcare research by providing detailed information about the healthcare workforce.
• Provider Verification: Ensuring that healthcare providers are properly credentialed and authorized to practice.
• Healthcare Operations: Facilitating healthcare operations through reliable provider information for patient referrals and inter-provider communication.

Where Can I Buy NPI Data?

You can explore our data marketplace to find a variety of NPI Data tailored to different use cases. Our verified providers offer a range of solutions, and you can contact them directly to discuss your specific needs.

How is the Quality of NPI Data Maintained?

The quality of NPI Data is ensured through rigorous validation processes, such as cross-referencing with reliable sources, monitoring accuracy rates, and filtering out inconsistencies. High-quality datasets often report match rates, regular updates, and adherence to industry standards.

How Frequently is NPI Data Updated?

The update frequency for NPI Data varies by provider and dataset. Some datasets are refreshed daily or weekly, while others update less frequently. When evaluating options, ensure you select a dataset with a frequency that suits your specific use case.

Is NPI Data Secure?

The security of NPI Data is prioritized through compliance with industry standards, including encryption, anonymization, and secure delivery methods like SFTP and APIs. At Datarade, we enforce strict policies, requiring all our providers to adhere to regulations such as GDPR, CCPA, and other relevant data protection standards.

How is NPI Data Delivered?

NPI Data can be delivered in formats such as CSV, JSON, XML, or via APIs, enabling seamless integration into your systems. Delivery frequencies range from real-time updates to scheduled intervals (daily, weekly, monthly, or on-demand). Choose datasets that align with your preferred delivery method and system compatibility for NPI Data.

How Much Does NPI Data Cost?

The cost of NPI Data depends on factors like the datasets size, scope, update frequency, and customization level. Pricing models may include one-off purchases, monthly or yearly subscriptions, or usage-based fees. Many providers offer free samples, allowing you to evaluate the suitability of NPI Data for your needs.