The Medicare Fee-For-Service Public Provider Enrollment dataset includes information on providers who are actively approved to bill Medicare or have completed the 855O at the time the data was pulled from the Provider Enrollment, Chain, and Ownership System (PECOS). The release of this provider enrollment data is not related to other provider information releases such as Physician Compare or Data Transparency.

 

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

In the May 2020 CMS Interoperability and Patient Access final rule, CMS finalized the policy to publicly report the names and NPIs of those providers who do not have digital contact information included in the NPPES system (85 FR 25584). This data includes the NPI and provider name of providers and clinicians without digital contact information in NPPES.

The Opioid Treatment Program (OTP) Providers dataset provides information on Providers who have enrolled in Medicare under the Opioid Treatment Program. It contains provider's name, National Provider Identifier (NPI), address, phone number and the effective enrollment date.

The Order and Referring dataset provides information on all physicians and non-physician practitioners, by their National Provider Identifier (NPI), who are of a type/specialty that is legally eligible to order and refer in the Medicare program and who have current enrollment records in Medicare. 

 

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

The CMS Program Statistics - Medicare Providers summary tables provide data on institutional (i.e., hospitals, skilled nursing facilities, home health agencies, hospices, etc.) and non-institutional (i.e., physicians, nonphysicians, specialists, and suppliers) providers. 

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data.

 

Below is the list of tables:

MDCR PROVIDERS 1.  Medicare Providers: Number of Medicare Certified Institutional Providers, Yearly Trend
MDCR PROVIDERS 2.  Medicare Providers:  Number of Medicare Certified Inpatient Hospital and Skilled Nursing Facility Beds and Beds Per 1,000 Enrollees, Yearly Trend
MDCR PROVIDERS 3.  Medicare Providers:  Number of Medicare Certified Facilities, by Type of Control, Yearly Trend
MDCR PROVIDERS 4.  Medicare Providers:  Number of Skilled Nursing Facilities and Medicare Certified Hospitals, and Number of Beds, by State, Territories, Possessions and Other Areas
MDCR PROVIDERS 5.  Medicare Providers:  Number of Medicare Certified Providers, by Type of Provider, by State, Territories, Possessions, and Other Areas
MDCR PROVIDERS 6.  Medicare Providers:  Number of Medicare Non-Institutional Providers by Specialty, Yearly Trend
MDCR PROVIDERS 7.  Medicare Providers:  Number of Medicare Non-Institutional Providers, by State, Territories, Possessions, and Other Areas, Yearly Trend

The Fiscal Intermediary Shared System (FISS) Attending and Rendering dataset provides a list of those attending and rendering physicians for the FISS. FISS edits require that the Line Item Rendering Physician information be transmitted when providers submit a combined claim. Claims that include both facility and professional components, need to report the rendering physician or other practitioner at the line level if it differs from the rendering physician/practitioner reported at the claim level.

 

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

The Pending Initial Logging and Tracking (L & T) Physicians dataset provides a list of pending applications that have not been processed by CMS contractors.

The Skilled Nursing Facility (SNF) All Owners dataset provides information on all owners of SNFs currently enrolled in Medicare. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

ATTENTION USERS

Some Providers' Opt-Out Status may end early due to COVID 19 waivers. Please contact your respective MAC for further information.

 

For more information on the opt-out process, see Manage Your Enrollment or view the FAQ section below.

 

The Opt Out Affidavits dataset provides information on providers who have decided not to participate in Medicare. It contains provider's NPI, specialty, address, and effective dates.

The Pending Initial Logging and Tracking (L & T) Non Physicians dataset provides a list of pending applications that have not been processed by CMS contractors for Non Physicians.