Provider Enrollment, Chain and Ownership System (PECOS) ID's are assigned to healthcare providers by Centers for Medicare & Medicaid Services (CMS) when they enroll in the Medicare provider online enrollment system.
Starting on January 6, 2014, Medicare claims have been denied for services or supplies that require an order/referring provider to be identified, but the provider is not identified, not in Medicare�s enrollment records, or is not of a specialty type that may order or refer the service/item being billed.
This free online PECOS search can be used to search by NPI or first name, last name. Addtionally, a state(including territories) can be selected.
The PECOS database was last updated 11/24/2020. The database is comprised of 1,606,978 records.
In this update, 1,719 records were added and 35,674 records were removed compared to the previous update.
CMS updates this PECOS data, including adding and dropping providers, many times during the week. We have automated the process of bulk pecos search and keeping track of all updates with our PECOS Monitoring solution. Here's all you have to do:
The NPI Database was last updated on 11/21/2020 with 6,608,767 records.
If you would like to validate or update your NPI in PECOS, please visit the CMS PECOS Medicare Enrollment page.
Find NPI information searching by name or NPI. Additionally, you can enter a partial name.
Only physicians and certain other eligible professionals are eligible to order or refer items or services for Medicare beneficiaries. Claims edits were implemented to check the following claims for an approved enrollment and valid individual National Provider Identifier (NPI) and deny the claim when this information is invalid:
DME — Eligible to order/refer Durable Medical Equipment (DME) - Claims from suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) for ordered DMEPOS
HHA — Eligible to order/refer Home Health Agency (HHA) - Claims from Part A Home Health Agencies (HHAs)
PMD — Eligible to order/refer Power Mobility Devices (PMD) - Claims from Power Mobility Devices (PMD)
Are you interested in PECOS Bulks Searches?
CMS updates this PECOS data, including adding and dropping providers, multiple times per week. We have automated the process of keeping track of all updates with our PECOS Monitoring solution. Here's all you have to do: