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Public provider data: NPPES, CMS and HRSA

Search engines, insurers and directories cross-check clinics against public federal records. These datasets are free from the government. Keeping your entries accurate is part of being findable.

Last reviewed against the sources listed at the end.

The main datasets

Federal provider datasets
DatasetPublisherWhat it recordsAccess
NPPES NPI RegistryCMSEvery NPI: Type 1 for individual clinicians, Type 2 for organisations, with taxonomy (specialty) codes and practice addressesSearch, API, full download
Provider Data CatalogCMSMedicare-enrolled clinicians and facilities, the data behind Medicare Care Comparedata.cms.gov/provider-data
Health center sitesHRSALocations of HRSA-funded health centers, including Federally Qualified Health Centersdata.hrsa.gov

An NPI is a 10-digit identifier. It shows that a clinician or organisation registered with CMS; it is not a license and does not show board certification. Licensing is verified with each state's licensing board.

How ClinicStats uses NPPES

The "Providers listed and verified" check reads provider names and credentials from your site, then looks for matching active records through the public NPPES API. A match tells patients and search engines that the people named on your site are real, registered clinicians. When names are listed but none match, the usual cause is a nickname, a missing middle initial or a record with an old practice address.

Keep your own records current

  • CMS requires providers to report changes to their NPPES information within 30 days. Update practice location and phone after a move, for each clinician and for the organisation NPI.
  • Use the same practice name and address in NPPES, on your Google Business Profile and on your website.
  • If you bill Medicare, check that your Care Compare listing shows the right specialty and location; it is drawn from Medicare enrollment, not from NPPES.

What the ClinicStats scan checks here

Related checks and their pass rules
CheckSub-scorePasses when
Providers listed and verified (NPI)TrustedThe homepage or team page names at least one provider with a credential (MD, DO, NP, PA, DDS, PhD, LCSW, etc.) or the title "Dr.", and at least one name matches an active record in the CMS NPPES NPI Registry.
Name, address and phone match GoogleFindableThe phone number and street address on the website match the Google Business Profile listing.

See whether your providers match NPPES

The scan reads the clinicians named on your site and looks for them in the NPI Registry. The report lists what matched.

Enter at least one. Your report shows on screen right away and is emailed to you when you give an email.

We email your report and occasional updates from ClinicStats. Unsubscribe anytime.

Checking you are human…

Questions

Does ClinicStats sell CMS or NPPES data?

No. These datasets are free from CMS and HRSA. ClinicStats only queries the public NPI Registry to verify the providers named on a scanned site.

Our NPI record is right but the check still says borderline. Why?

The match is by name. If your site lists "Dr. Kate Smith" and NPPES has "Katherine A. Smith", add the full legal name to the provider profile on your site.

Sources

  1. NPPES NPI Registry, Centers for Medicare & Medicaid Services
  2. NPPES NPI Registry API, Centers for Medicare & Medicaid Services
  3. NPPES downloadable files, Centers for Medicare & Medicaid Services
  4. Provider Data Catalog, Centers for Medicare & Medicaid Services
  5. HRSA Data Warehouse, Health Resources and Services Administration