Medicare Revalidation Due Date List API
Medicare Providers must validate their enrollment record every three or five years. CMS sets every Provider’s Revalidation due date at the end of a month and posts the upcoming six to seven months of due dates online. A due date of ‘TBD’ means that CMS has not set the due date yet. These lists are refreshed every two months and two months’ worth of due dates are appended to the list.
The Revalidation Due Date List dataset contains revalidation due dates for Medicare providers who are due to revalidate in the following six months. If a provider’s due date does not fall within the ensuing six months, the due date is marked ‘TBD’. In addition the dataset also includes subfiles with reassignment information for a given provider as well as due date listings for clinics and group practices and their providers. This dataset is based on information gathered from the Provider Enrollment, Chain and Ownership System (PECOS).
revalidation_date(enroll_id = "I20031110000070",
npi = 1184699621)
#> # A tibble: 1 × 13
#> npi enroll_id first_name last_name organization_name enroll_state
#> <chr> <chr> <chr> <chr> <chr> <chr>
#> 1 1184699621 I20031110000070 Eric Byrd NA NC
#> # ℹ 7 more variables: enroll_type <chr>, enroll_desc <chr>,
#> # enroll_specialty <chr>, revalidation_due_date <date>,
#> # adjusted_due_date <date>, group_reassignments <chr>, ind_associations <int>
revalidation_date(first_name = "Eric",
last_name = "Byrd")
#> # A tibble: 2 × 13
#> npi enroll_id first_name last_name organization_name enroll_state
#> <chr> <chr> <chr> <chr> <chr> <chr>
#> 1 1184699621 I20031110000070 Eric Byrd NA NC
#> 2 1598792285 I20090128000461 Eric Byrd NA SC
#> # ℹ 7 more variables: enroll_type <chr>, enroll_desc <chr>,
#> # enroll_specialty <chr>, revalidation_due_date <date>,
#> # adjusted_due_date <date>, group_reassignments <chr>, ind_associations <int>
revalidation_date(state = "FL",
type_code = "3",
specialty = "General Practice")
#> # A tibble: 1,560 × 13
#> npi enroll_id first_name last_name organization_name enroll_state
#> <chr> <chr> <chr> <chr> <chr> <chr>
#> 1 1184693400 I200311040005… John Abt NA FL
#> 2 1356436786 I200311050000… Humberto Fernande… NA FL
#> 3 1467499285 I200311050005… Jorge Santander NA FL
#> 4 1104875178 I200311110006… Marianela De La Po… NA FL
#> 5 1437205796 I200312040005… Mohammad Sheikh NA FL
#> 6 1417063454 I200312090007… Richard Rizzo NA FL
#> 7 1689646440 I200312110003… Rene Casanova NA FL
#> 8 1265580146 I200312110010… Maria Monteale… NA FL
#> 9 1619943990 I200312150002… Ricardo Dominguez NA FL
#> 10 1033218821 I200312150003… Arles Perdomo NA FL
#> # ℹ 1,550 more rows
#> # ℹ 7 more variables: enroll_type <chr>, enroll_desc <chr>,
#> # enroll_specialty <chr>, revalidation_due_date <date>,
#> # adjusted_due_date <date>, group_reassignments <chr>, ind_associations <chr>Data Dictionary
| Variable | Description |
|---|---|
|
Enrollment ID
Enrollment ID
|
|
National Provider Identifier
National Provider Identifier (NPI)
|
|
First Name
First name of individual provider
|
|
Last Name
Last name of individual provider
|
|
Organization Name
Legal business name of organizational provider
|
|
Enrollment State Code
Enrollment state
|
|
Enrollment Type
Provider type code (1 if Part A; 2 if DME; 3 if Non-DME Part B)
|
|
Provider Type Text
Provider type description
|
|
Enrollment Specialty
Enrollment specialty
|
|
Revalidation Due Date
Previously assigned revalidation due date (blank if not previously assigned a due date)
|
|
Adjusted Due Date
Next revalidation due date (blank if not yet assigned)
|
|
Individual Total Reassign To
Number of individual enrollment associations that are reassigning benefits to or are employed by the organizational provider
|
|
Receiving Benefits Reassignment
Number of organizational enrollment associations to which the individual provider reassigns benefits or is employed by
|
Medicare Revalidation Clinic Group Practice Reassignment API
revalidation_group(ind_enroll_id = "I20200929003184",
ind_npi = 1962026229,
ind_first = "Rashadda",
ind_last = "Wong",
ind_state = "CT",
ind_specialty = "Physician Assistant")
#> Error in revalidation_group(ind_enroll_id = "I20200929003184", ind_npi = 1962026229, : unused arguments (ind_enroll_id = "I20200929003184", ind_npi = 1962026229, ind_first = "Rashadda", ind_last = "Wong", ind_state = "CT", ind_specialty = "Physician Assistant")
revalidation_group(group_pac_id = 9436483807,
group_enroll_id = "O20190619002165",
group_bus_name = "1st Call Urgent Care",
group_state = "FL",
record_type = "Reassignment")
#> Error in revalidation_group(group_pac_id = 9436483807, group_enroll_id = "O20190619002165", : unused arguments (group_pac_id = 9436483807, group_enroll_id = "O20190619002165", group_bus_name = "1st Call Urgent Care", group_state = "FL")Data Dictionary
| Variable | Description |
|---|---|
|
Group PAC ID
PAC ID of provider who is receiving reassignment or is the employer
|
|
Group Enrollment ID
Enrollment ID of provider who is receiving reassignment or is the employer
|
|
Group Legal Business Name
Legal business name of provider who is receiving reassignment or is the employer
|
|
Group State Code
Enrollment state of provider who is receiving reassignment or is the employer
|
|
Group Due Date
Revalidation due date of provider who is receiving reassignment or is the employer (TBD if yet to be assigned)
|
|
Group Reassignments and Physician Assistants
Number of individual enrollment associations that are reassigning benefits to or are employed by the organizational provider
|
|
Record Type
Identifies whether the record is for a reassignment ('Reassignment') or employment ('Physician Assistant')
|
|
Individual Enrollment ID
Enrollment ID of provider who is reassigning their benefits or is an employee
|
|
Individual NPI
NPI of provider who is reassigning their benefits or is an employee
|
|
Individual First Name
First name of provider who is reassigning their benefits or is an employee
|
|
Individual Last Name
Last name of provider who is reassigning their benefits or is an employee
|
|
Individual State Code
Enrollment state of provider who is reassigning their benefits or is an employee
|
|
Individual Specialty Description
Enrollment specialty of the provider who is reassigning their benefits or is an employee
|
|
Individual Due Date
Revalidation due date of the provider who is reassigning their benefits or is an employee (TBD if yet to be assigned)
|
|
Individual Total Employer Associations
Number of organizational enrollment associations to which the individual provider reassigns benefits or is employed by
|
Medicare Revalidation Reassignment List API
Reassignments of Providers who are due for Revalidation.
The Revalidation Reassignment List dataset provides information on reassignments of providers who are due for revalidation. Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers/suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. CMS has completed its initial round of revalidations and will be resuming regular revalidation cycles in accordance with 42 CFR §424.515. In an effort to streamline the revalidation process and reduce provider/supplier burden, CMS has implemented several revalidation processing improvements one of which is established due dates by which Providers must revalidate. Medicare Providers must validate their enrollment record every three or five years. CMS sets every Provider’s Revalidation due date at the end of a month and posts the upcoming six to seven months of due dates online. A due date of ‘TBD’ means that CMS has not set the due date yet.
revalidation_reassign(ind_enroll_id = "I20200929003184",
ind_npi = 1962026229,
ind_first = "Rashadda",
ind_last = "Wong",
ind_state = "CT",
ind_specialty = "Physician Assistant")
#> Error in revalidation_reassign(ind_enroll_id = "I20200929003184", ind_npi = 1962026229, : unused arguments (ind_enroll_id = "I20200929003184", ind_npi = 1962026229, ind_first = "Rashadda", ind_last = "Wong", ind_state = "CT", ind_specialty = "Physician Assistant")