Tuesday, April 05, 2016

#ONCPDW #PDWorkshop Modernizing NPPES – Peter Gilbert

Modernizing NPPES

  • Where we were
  • Where NPPES is going


10 digit number

Type 1 = Individuals
Type 2 = Organizations

Organizations can have multiple NPIs

26K new per month
63K Updates

The Past

NPPES was a number generator

2016 industry sees NPPES as a directory.

  • NPPES not designed as a directory


  • Adopt best-practices from consumer web sites.
  • Use Federal design standards
  • Increase the relevance
  • Align and integrate with other programs
  • increase integrity (consistency, freshness, valid, recertification) – Role in Fraud Prevention

The Path

  • Alan Viars – EIR
  • New Public Search
  • Open Source
  • Modern Technologies

In 2015 launched real-tim NPPES Search.

In 2016 deliver a new provider experience:
– Modern look
– Easier screens
– Clearer Expectations
– Surrogacy (for organization administrators)
– more optional identifiers – including Direct Addresses
– Data and reporting

In 2017 – more improvements:
– Automation
– Integrity (anti-fraud measures, cross-referencing)
– Enforcement and NPI Deactivation
– Notify discrepancies via email

Look at Data input to NPPES via API


  • Looking to how to disclose group affiliations without disclosing Tax ID.

Will be adding in multiple practice locations and enabling a default

NPI Final rule dictates what information is maintained.
Provider has to confirm the information.

Presenter: Richard Gilbert, CMS – CPI

via WordPress http://2.healthca.mp/25JfqL0