02/04/2026
Your NPPES portal data isn’t a “set-it-and-forget-it” task — it’s a revenue risk and credentialing driver.
Your information in the National Plan and Provider Enumeration System (NPPES) — the official CMS system for provider and organization IDs feeds directly into PECOS, CAQH ProView, and payer networks. If that data is outdated, inconsistent, or incomplete, credentialing delays and payment issues often follow.
Here’s what practices are overlooking:
🔹 Taxonomy codes must match what you actually bill — mismatches trigger flags and denials.
🔹 Updates must happen within 30 days of changes — like address, ownership, or specialty shifts.
🔹 NPPES is the source of truth — fixing CAQH or PECOS alone won’t solve credentialing errors if NPPES is wrong.
🔹 Small mistakes in NPPES (old addresses, wrong NPIs, outdated taxonomy) can lead to delayed payments or retroactive denials.
Strong NPPES management isn’t reactive — it’s part of your ongoing revenue cycle strategy. Quarterly reviews, alignment with other enrollment systems, and documented workflows can save time and protect cash flow.
Read the full article here: https://hubs.ly/Q041NRnV0
Practice managers: What’s the biggest challenge you’ve faced keeping your practice's NPPES data accurate?
Learn how medical practices should use the NPPES portal to avoid credentialing delays, claim denials, and enrollment issues caused by outdated or incorrect NPI data.