This is a list of active Medicaid fee-for-service (FFS), Managed Care Only and Ordering, Prescribing, Referring, Attending (OPRA) providers. Data elements include the provider’s Medicaid Provider ID, NPI, provider or facility name, Medicaid type, profession or service, provider specialty, service address, city, state, zip code, county, telephone number, latitude, longitude, enrollment begin date, next anticipated revalidation date, date the file was extracted from the data warehouse and a Medically Fragile Children and Adults Directory Indicator.
This dataset has the following 19 columns:
| Column Name | API Column Name | Data Type | Description | Sample Values |
|---|---|---|---|---|
| MEDICAID PROVIDER ID | mmis_id | text | A unique number assigned to each provider enrolled to provide services to members of the Medicaid program. This number is the primary method of identifying a provider. | 03002917 02996078 02350136 00354967 03450460 view top 100 |
| NPI | npi | text | National Provider ID (NPI) is a standard unique identifier for health care providers. This NPI relates to the MMIS ID and is the most current NPI on file. | 1457395766 1619341716 1285826438 1104982917 1053688572 view top 100 |
| PROVIDER OR FACILITY NAME | mmis_name | text | The name of a provider of Medicaid services as used on official State records. | UNITY HOSPITAL ROCHESTER NYU LANGONE HOSPITALS NEW YORK PRESBYTERIAN HOSPITAL ROCHESTER GENERAL HOSPITAL ST PETERS HOSPITAL ALBANY view top 100 |
| MEDICAID TYPE | medicaid_type | text | FFS (Fee for Service Medicaid): Provider is enrolled and participating in the Medicaid fee for service program. The provider may or may not be a participating provider in the Medicaid managed care program. MCO (Managed Care Only): Provider is enrolled but cannot bill the Medicaid fee for service program. The provider is a participating provider in the Medicaid managed care program. OPRA (Ordering, Prescribing, Referring, Attending): Provider is enrolled and participating in the Medicaid program as a non-billing provider. | FFS OPRA MCO view top 100 |
| PROFESSION OR SERVICE | profession_or_service | text | Specifies the broad areas of service that a provider can render. | PHYSICIAN NURSE PRACTITIONER PHYSICIAN ASSISTANT PHYSICIAN GROUP PRACTICE PHYSICAL THERAPIST view top 100 |
| PROVIDER SPECIALTY | provider_specialty | text | Identifies the medical specialty for which a provider is certified. | DIAGNOSTIC RADIOLOGY INTERNAL MEDICINE ANESTHESIOLOGY PEDIATRICS EMERGENCY MEDICINE view top 100 |
| SERVICE ADDRESS | service_address | text | Address related to the service address for the Medicaid provider ID. | 300 COMMUNITY DR 270-05 76TH AVE 1275 YORK AVE 111 E 210TH ST 601 ELMWOOD AVE view top 100 |
| CITY | city | text | The City related to the service address for the Medicaid provider ID. | NEW YORK BROOKLYN BRONX ROCHESTER STATEN ISLAND view top 100 |
| STATE | state | text | State related to the service address for the MMIS ID. | NY PA NJ VT CT view top 100 |
| ZIP CODE | zip_code | text | Zip Code related to the service address for the Medicaid provider ID. | 11030-3816 11040-1402 10016-6402 10467-2401 14642-0001 view top 100 |
| COUNTY | county | text | County related to the service address for the MMIS ID. | NEW YORK NASSAU KINGS SUFFOLK QUEENS view top 100 |
| TELEPHONE | telephone | text | Telephone number related to the service address for the Medicaid provider ID. | 8446924692 2122635072 5167171839 2126392000 9525951301 view top 100 |
| LATITUDE | latitude | text | Latitude related to the service address for the Medicaid provider ID. –nn.dddddddddddd (example: Zip Code 10029-4623 would reflect Latitude 40.7920468) | 40.77962 40.75403 40.74225 40.88002 43.12427 view top 100 |
| LONGITUDE | longitude | text | Longitude related to the service address for the Medicaid provider ID. nnn.dddddddddddd (example: Zip Code 10029-4623 would reflect Longitude ¬-73.9444103) | -73.70298 -73.7059 -73.9745 -73.88072 -77.62484 view top 100 |
| ENROLLMENT BEGIN DATE | enrollment_begin_date | calendar_date | Most recent date the provider began participating in NYS FFS Medicaid/OPRA/ Managed Care Only. mm/dd/ccyy with leading zeros | 2014-01-01T00:00:00.000 2020-03-01T00:00:00.000 2020-12-11T00:00:00.000 2017-09-01T00:00:00.000 1979-08-01T00:00:00.000 view top 100 |
| NEXT ANTICIPATED REVALIDATION DATE | next_anticipated_revalidation_date | calendar_date | Date the provider is subject to revalidate. mm/dd/ccyy with leading zeros | 2025-01-01T00:00:00.000 2026-01-07T00:00:00.000 2023-12-01T00:00:00.000 2024-03-01T00:00:00.000 2024-06-01T00:00:00.000 view top 100 |
| FILE DATE | updated | calendar_date | Date the file was created at eMedNY. mm/dd/ccyy with leading zeros | 2024-06-03T00:00:00.000 view top 100 |
| MEDICALLY FRAGILE CHILDREN AND ADULTS DIRECTORY IND | medically_fragile_children_directory_ind | text | Indicator to identify provider enrolled in the Medically Fragile Children Directory. Indicator will be Y for Yes and N for No | N Y view top 100 |
| PROVIDER EMAIL | provider_email | text | The provider email address related to the service address for the Medicaid provider ID. Email address will only be included for Provider Duty Nursing (PDN) providers. All other provider records will be blank. | JMCCARTHY@UCICARE.COM LOUGHREYBETTIE78@GMAIL.COM PRISCAMOKY@GMAIL.COM FOSTECM@UPSTATE.EDU LESIACHRISTEN6@GMAIL.COM view top 100 |