Direct Addresses in NPPES as Part of the Public NPI Dissemination File

[Alan Viars]

ALCON:

I've talked to many health IT folks about provider directories and their relation to NPPES/NPIs.  As most of you reading this group post know, I am currently a federal employee working on "Modernizing NPPES" as an HHS Entrepreneur Fellow at CMS. Adding Direct addresses is a requirement/request we have from heard from a number of people. I have rewritten NPPES from the ground up using a more modern web technology, Django.  The debate seems to be around having the Direct addresses public or not.  Some folks from ONC have suggested that the provider Direct address discovery function should be "opaque".  My personal opinion is that it should be public, but I'd like to get a definitive answer from the Direct community and/or the health IT standards community.

Right now in the new NPPES can store 0..n Direct addresses.  There is a "public" flag that is defaulted to True.  Direct addresses are optional.  The "NPI Final Rule" is the regulation that started NPIs. The "NPI Final Rule" defines what is required as part of an NPI record.  Nothing beyond that can be required without additional regulations or changes to the existing regulation.

CMS is interested in making sure the information in NPPES is up to date. This particularly means contact persons, mailing addresses, and practice addresses.  This is also a big focus of my fellowship.

I would agree that the national registry of providers (NPPES) is an ideal place to put Direct addresses.  The new NPPES will have a simple RESTFul API where you can search for information including Direct addresses.  The plan is for the new system to go live in early 2015.

I am told by CMS that PECOS information will soon be public. This would make public which doctor is working for which organization or organization that bill to Medicaid.  PECOS is the system for Medicare provider enrollment. You pretty much need an NPI to practice medicine in the US, but not all doctors provide care under Medicare.

The source code for the new NPPES may be found at https://github.com/HHSIDEAlab/npi . You can see the Direct data models in apps/direct/models.py. Just a reminder, pull requests will be considered.   See my earlier post on that topic. Also, I have a splash page for the NPPES Modernization effort in general. Please see  http://npi.io for more information.

I've heard many people tell me that think HPD+ over SOAP over LDAP is very complicated to implement.  I tend to agree.  On a similar note, I think that certificate discovery would be much easier over HTTP rather than LDAP/DNS.  U'm not going to go into details again here, but in short its because its complicated and increases the complexity necessary to implement Direct. This is my opinion, and not an official CMS position.  I did spec out a model for storing x509 certificates in NPPES (and serving them publicly over HTTP) but that feature is disabled at the moment.  Any thoughts?

Sincerely,

Alan Viars

HHS Entrepreneur Fellow at CMS

Center for Program Integrity (CPI)

Provider Enrollment Operations Group (PEOG)