Modernizing NPPES

Where we were
Where NPPES is going

NPI

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

Objectives

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

Affiliations

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

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