Overview of the NPPES/NPI Downloadable File

Purpose

The CMS National Plan and Provider Enumeration System (NPPES) provides basic information about all organization and individual providers with a National Provider Identifier (NPI). This article provides a brief overview of how to access the NPPES and the information that it contains.

Current Version Date:
07/20/2018
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The National Provider Identifier

The National Provider Identifier (NPI) is unique identification number for health care providers, including both organizations and individuals. The NPI is a 10-position numeric identifier that allows researchers to identify a unique provider. The NPIs are unencrypted in the RIF data and encrypted in the LDS data for years 1999-2012. The NPI is unencrypted in the LDS data starting with year 2013.

Accessing the NPPES

Researchers are often interested in a source that provides them with a list of all Medicare professional providers. A full list of all providers with a National Provider Identifier (NPI), both organizations and individuals, can be found in the National Plan and Provider Enumeration System (NPPES). Information in the NPPES can be accessed through a query-able database called the NPI Registry or as a downloadable file (often referred to as the “NPI Downloadable File”).

Opening the Downloadable File

The above link for the NPI Downloadable File provides instructions for opening the file, as well as links to code values, a readme document, and a file header. There is also a separate link for the actual data file. The file is very large and cannot be opened in Microsoft Excel. 

Data Contents

The file is updated weekly and monthly and each updated file contains the most current information from NPPES. Historical downloadable files are not maintained. NPPES health care provider data that are disclosable under the Freedom of Information Act (FOIA) are released. Details on the variables included can be found by visiting the links above.

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Article Information

Author:
Faith Asper, MHS, CIPP/G
Acknowledgements:
ResDAC would also like to acknowledge Erin Mann and Sarah Garcia for assistance with this article.
Level:
Introduction
Topic:
Data Files or Variables
Program:
Medicare
Category:
Plan and Provider
Disclaimer:
The process and materials mentioned as part of this KnowledgeBase article are current, as of the publication date on the article, to the best of our knowledge. The examples provided are correct in the aggregate but may not apply to every subgroup or circumstance that a researcher may wish to study. It is up to the researcher to conduct analysis and confirm that the patterns described in this KnowledgeBase article apply to his/her particular study. If your research findings appear to contradict the advice provided, please contact ResDAC at resdac@umn.edu.