Required Fields for clinician demographics:

The following data elements are core data needs and critical requirements for the clinical demographics data proof of concept exercise.

Line Required Column Description PI
1 Required LastName MiddleName  
2 Required FirstName FirstName  
3 Required MiddleName MiddleName  
4 Required Suffix Suffix  
5 Required TaxIDindividual Tax ID number associated with provider (individual practitioner) Y*
6 Required TaxIDinstitution Tax ID number associated with provider (institution) For employers, including state and local government agencies and non profit organizations , TIN is the IRS issued employer identification number (EIN). EINS are public information per FCC  
7 Required NPI NPI  
8 Required HCPT Spec Code Health Care PRovider Taxonomy- Industry standard speciality codes (for complete code list see )  
9 Required isAcceptingPatients provider is accepting the patients for the payer products: only existing patients, family members of existing patients, new patients, other per Provider/Prayer  
10 Required PayerNtwkEffDate Date the provider joined this network. (at the group level for POC purposes)  
11 Required PayerNtwkExpireDate Date the provider leaved this network. (at the group level for POC purposes)  
12 Required Site/Location EffectiveDate Provider’s start date at this location  
13 Required Site/LocationTerminationDate Provider’s end date at this location  
14 Required PracticeStreet1 Provider’s place of medical service, practice address street line 1  
15 Required PracticeStreet2 Practice address street line 2  
16 Required PracticeCity Practice city  
17 Required PracticeState Practice state  
18 Required PracticeZip PracticeZip  
19 Required PracticeTelephone Practice phone (can he have multiple types by location, ie, appointment, business line )  



Non Critical Data:

If the data is available, other non-critical data are also requested but not required. A sampling is listed below

Line Data Needed Column Description PI
20 High PrimaryContactName Practice contact name  
21 High PrimaryContactFax Fax  
22 High ProviderRetireDate Date of the provider Retired  
23 High ProviderDecreaseDate Date of the provider decreased  
24 High ProviderProficiencyEnglish Provider’s proficiency in the English language  
25 High ProviderOtherLanguages Languages spoken by the provider (other than English)  
26 High SiteProficiencyEnglish Staff proficiency in the English language.