Payer price transparency data is poised to become a valuable tool for healthcare providers, analysts, and consumers. Here at Hannalytics, we frequently analyze payer transparency files, linking National Provider Identifier (NPI) numbers to payer-specific reimbursement information and other provider details. While these files serve as a powerful resource, one notable privacy consideration has emerged that I want to spend some time outlining: in some cases, the address linked to an NPI may be a provider’s home address or may be incorrect altogether. This article will explore why this happens, the potential privacy concerns, and steps providers can take to check and update their NPI information in the NPPES system.
Understanding NPI and NPPES
The National Provider Identifier (NPI) is a unique 10-digit identification number assigned to healthcare providers in the United States. Managed by the National Plan and Provider Enumeration System (NPPES ), the NPI is required by HIPAA-covered entities and is used across various electronic transactions and databases. NPI information includes provider details such as name, specialty, and practice location(s). However, in certain instances, the address associated with an NPI may unintentionally reveal sensitive information, including a provider’s residential address.
Why Home Addresses Appear in Transparency Data
When providers initially apply for their NPI, they supply a practice or mailing address. Many choose to use a practice location, but in some cases, a home address may be used, often as a mailing address. This can inadvertently lead to privacy issues, as payer transparency files may pull and display this address, exposing it to the public. New providers may use their home address in the event they do not have a “practice location” quite yet.
Implications for Data Use
For analysts and organizations using NPI-linked data, this mix of address types means that due diligence is crucial. Mistaking a residential address for a business location could misrepresent the provider’s professional footprint. Furthermore, this privacy vulnerability may lead to unintended consequences, such as unwanted solicitation or privacy invasions.
Checking and Updating Your NPI Information
To safeguard privacy, providers can and should review their NPI details periodically. The NPPES system allows providers to verify and, if needed, update their contact information.
- Visit the NPPES NPI Registry: https://npiregistry.cms.hhs.gov/
- Providers can search for their NPI and verify the information on file.
- Log in to NPPES : If changes are needed, providers can log into their NPPES account: https://nppes.cms.hhs.gov/.
- From here, they can update addresses, specialties, and other relevant details.
- Tip: If using a personal address as the mailing address, consider updating this to an office address or PO box to protect privacy.
- Update or Correct NPI Information: Follow the step-by-step instructions provided in the NPPES portal to submit updates securely.
For additional assistance, providers can contact NPPES support at 1-800-465-3203.
Stay Informed
The healthcare transparency landscape continues to evolve, and so does the data collected, displayed, and utilized by third parties. By staying informed about what information is available and ensuring it accurately reflects their preferences, providers can maintain a more secure online presence.