Medicare Physician Identification and Eligibility Registry (MPIER) File

A system of physician identifiers was mandated by S9202 of the Consolidated Omnibus Budget Reconciliation Act of 1985. It requires a unique identifier for each physician who provides services for which Medicare payment is made. The Unique Medicare Physician Identification Number (UPIN) is established in a national Registry of Medicare Physician Identification and Eligibility Records. This file contains certain data elements from the physician in order to assure accurate physician identification.

File Creation

Transamerica Occidental Life Insurance Company is the Registry Carrier that establishes and maintains the national registry of physicians. The Part B Medicare carriers submit additions, updates and deletions directly to the central registry on behalf of the physicians.

File Maintenance

OIS receives a copy of the registry file on a quarterly basis. This file is maintained on both cartridge and an online mainframe SAS database.

File Structure and Usage

The MPIER File contains information about a physician pertinent to each active practice setting which they maintain. This information contains, but is not limited to, business address, billing address, primary specialty, date of birth, medical school, date of graduation, State license number and Medicare billing number. The file is used for research, distribution to the Peer Review Organizations (PROs), creation of an electronic directory which is distributed by the Government Printing Office (GPO) and other CMS (previously HCFA) central office analyses.

Data Structure and Usage

Each record on the file represents one practice setting for a physician/practitioner. The MPIER File is a sequential flat file containing fixed length records. The record length is 255 characters. The records represent all practice settings currently recorded on the MPIER file to date. The records are sorted by the UPIN. There are approximately 2.5 million records on the file. Subsequent updates add approximately 10,000 records per quarter.

Methods of Access

A copy of the registry database is housed on-line at the CMS Data Center. An electronic directory of physicians is created from this database and distributed by GPO.

Migration of Data

The MPIER File was developed in 1993. Annual copies of this file are available for 1993 through 1996. It is intended that this file will be replaced in the future with the new National Provider File.

List of Data Elements

A list of the data elements contained in the MPIER File along with brief definitions and coding schemes, will be included in the future on the CMS web site at www.cms.hhs.gov.