Representing Health Care Providers

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Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Standard
Final
Production
Rating 4
Yes
Free
N/A
Standard
Final
Production
Rating 3
No
Free
N/A
Limitations, Dependencies, and Preconditions for Consideration Applicable Value Set(s) and Starter Set(s)
  • NPPES permits non-billable care team members to apply for an NPI number to capture the concept of ‘person’.
  • NPI taxonomy does not describe all roles associated with an individual’s care team, however, NUCC Health Care Provider Taxonomy codes cover concepts of other health care providers.

Comment

Broken link

The link to National Provider Identifier Standard Implementation/Specification is broken. Please correct.

Value set link and OID for NUCC Provider Taxonomy

  1. Please change the NUCC standard to "National Uniform Claim Committee (NUCC) Health Care Provider Taxonomy" Or you can just use NUCC Health Care Provider Taxonomy if you want it shorter. The provider taxonomy is the main thing people get from the NUCC, but NUCC provides other code sets so just saying NUCC is not specific. 
  2. The link you should use for the taxonomy is http://www.nucc.org/index.php/code-sets-mainmenu-41/provider-taxonomy-mainmenu-40
  3. VSAC provides a value set for the provider taxonomy. The OID is 2.16.840.1.114222.4.11.1066.
  4. VSAC has a direct link to the latest expansion for this value set here: https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.1066/expansion.
    1. This syntax will work for every value set VSAC has. I would suggest you use it for all VSAC value sets so users can click and directly go to the value set expansion view
  5. It would be good to standardize on how to represent OIDs. In some places you just list the OID, in others you list it as a URI (urn:oid:2.16.840.1.114222.4.11.1066)

Should NUCC Provider Taxonomy be used here?

Given that there is also a Representing Provider Role in Care Setting section that presumably is used to represent a care setting specific role, then some clarification is needed for how the NUCC PT code system would be used here, particularly when the NPI is not a role, it is an identifier. These are two very different kinds of concepts and I suspect they should not both be used here. Perhaps NUCC PT should only be used in the Representing Provider Role in Care Setting section.

NCPDP - Comment

The NPI is mandated in HIPAA named standard transactions; however other identifiers are used as needed (e.g.: State PDMP, state government programs)