Enrollment snapshot

See a provider's enrollment the way a payer sees it. Before anything is filed.

Enter an NPI. The snapshot reads the NPPES registry and the Medicare enrollment and revalidation files CMS publishes, then tells you what to check next. It is free, there is nothing to sign up for, and it reads public government data only.

Look up an NPI What each field means

iThe lookup

One number in, three public records out.

Enrollment snapshot

Public records only

The NPPES registry
The Medicare enrollment file
The Medicare revalidation list

Public government data only: the NPPES registry and two CMS files. No patient information is asked for or touched. The number you enter is never written to a log, and each result is kept for a day in our server cache so repeat lookups spare the public registries.

iiWhat each field means

What each line tells you.

NPPES is the national registry that issues every NPI. Payers read it when they process an application. PECOS is Medicare's own enrollment system, and CMS publishes a slice of it as a public file. The revalidation list is where CMS posts the date each Medicare enrollment has to be renewed.

Name and credential: Exactly as NPPES holds them. If the name differs from the license or the CAQH ProView profile (CAQH now operates as DataSpring), payers notice.
Entity type: Individual for a person, organization for a practice. A group bills under the organization NPI, and each provider still needs an individual one.
Primary taxonomy: The specialty code the provider chose in NPPES. It should match the specialty on every application.
License: The state license attached to that taxonomy. A provider practicing in a new state needs that state's license listed.
Practice address: Where care is given. Payers expect it to match the service location on the application.
Mailing address: Where letters go. It may differ from the practice address, and that is fine when it is intended.
Enumerated and last updated: When the NPI was issued and when the record last changed. A record untouched for a long time often still carries an old address.
Medicare provider type: How Medicare classifies the enrollment, for example a practitioner specialty or a clinic. It comes from the CMS public enrollment file.
Enrollment state: The state the Medicare enrollment is filed in. A provider can hold enrollments in more than one.
Revalidation due date: The date CMS has set for the enrollment to be renewed. CMS posts dates only for enrollments coming due soon, so a blank usually means the date is not posted yet.
Adjusted due date: A due date CMS has changed from the original. When one is listed, work to that date.

iiiWhat it cannot see

Public data answers some questions. A review answers the rest.

The CMS files are published on a cycle, not live. A provider who enrolled or revalidated after the last file will not show yet, so every result names the date of the file it came from. NPPES is read at the moment of the lookup.

Some records are not public at all. The PECOS application itself, the CAQH profile, commercial payer rosters and most Medicaid enrollments sit behind a login. The snapshot cannot compare them with NPPES, and it will never pretend to.

ivQuestions

Common questions about the snapshot.

Is the enrollment snapshot free?

Yes. There is no sign-up, no email and no limit on who can use it. It reads public government records and shows you what they say.

Where does the data come from?

Three public sources: the NPPES NPI Registry, the Medicare Fee-For-Service Public Provider Enrollment file and the Medicare Revalidation Due Date List. CMS runs all three. Each result names its source and the date of the file.

Why doesn't my Medicare enrollment show up?

There are three usual reasons. The provider does not bill Medicare. The enrollment was approved after CMS published its latest file. Or the number entered is the organization NPI while the enrollment sits under the individual one, or the reverse. Try the other NPI first.

Why is there no revalidation date?

CMS posts a revalidation date only when an enrollment is coming due. A blank does not mean the enrollment never needs renewing. It means the date is not posted yet.

Do you keep the numbers people look up?

We do not log them and we do not tie them to anyone. A result is held in our server cache for a day so a repeat lookup does not call the government registries again, and then it expires.

Can it check commercial payers or Medicaid?

No. Commercial payers and most state Medicaid programs do not publish enrollment in a form anyone can read. Checking them is part of the Payer Enrollment Sprint, payer by payer.

Found something in the record? We can take it from here.

Tell us about the practice and the payers that matter. The free review looks at what the snapshot cannot, and no patient data is needed for it.

Mention, in general terms, what the snapshot showed, so the review starts where it stopped.

Request a review