CMS Releases the NPI Crosswalk Implementation Strategy
The Centers for Medicare and Medicaid Services (CMS) has announced its strategy for disseminating data from the National Plan and Provider Enumeration System (NPPES). The NPPES data will be available on the Internet in downloadable and in query-only formats around the end of June.
The May 30, 2007 Federal Register Notice (vol. 72, no. 103) provides information about who may have access to the data, the process for requesting and receiving data, the conditions under which data may be disclosed, and when the system will become available for use.
NPPES data plays a major role in the implementation process for National Provider Identifiers (NPI). NPPES data enable providers to submit claim transactions with other provider NPI numbers by matching legacy identifiers (e.g., unique provider identification number) with NPI numbers. In order to comply with the Privacy Act, Health and Human Services (HHS) has removed providers’ social security numbers, IRS Individual Taxpayers Identification Numbers, and dates of birth from the data elements. The current NPPES data incorporate NPIs, entity types, names, addresses, gender, license numbers, and enumeration date as data elements.
There will not be a system that allows providers to submit requests for data to HHS since the data will be available on the Internet. The query-only data will enable users to run simple queries online. The downloadable format data will be updated each month with changes. CMS will announce the Web address of the files.