About NPI Data Services

Established in 2009, NPI Data Services, a leading Healthcare Risk Analytics and Data organization, began by providing healthcare provider data to health systems, pharmaceutical companies, labs, medical groups, recruitment companies, marketing companies, Revenue Cycle Management companies, government agencies, and health insurance companies. We also specialize in risk adjustment solutions, offering a comprehensive suite of intuitive tools for healthcare providers, health systems, health tech, and revenue cycle management companies to improve efficiencies, correct reimbursements, and patient care.

We gather data from various reliable sources, standardize, and stitch them together to create high-value healthcare data products, along with reliable & freshly updated healthcare provider data in an easy-to-understand and easy-to-use format. Our Provider Data Web Service is a REST API exposing the entire US provider data and Medicare enrollment data, and it can be looked up using National Provider Identifier (NPI), PECOS PAC ID, PECOS ENRLMT ID, provider names, and taxonomy codes.

We have further expanded and built tools to streamline the chart and diagnosis prioritization, ensuring accurate reimbursements in Concurrent, Retrospective, and Prospective reviews. These tools help make quick decisions like selecting charts for review, re-submission, clinical document improvement, provider education, and risk stratification in population health management.

Our Medicare HCC RAF Batch scoring tools analyze revenue impact for a large chart set, while our HCC RAF Score Analysis tools do the same for individual charts. Our Medicare HCC RAF Score API is a real-time REST API for CMS-HCC, RxHCC, and ESRD Risk Adjustment models. Plus, our population health tools identify and prioritize care for high-risk patients, predict future outcomes, engage patients, and assess program success.