National Provider Identifier (NPI) to Unique Physician Identification Number (UPIN) Crosswalk

Source CMS

The National Provider Indetifier (NPI) became the national standard identifier in May 2007.

The Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The NPPES files contain all of the FOIA-disclosable data for active and deactivated providers in NPPES.

The source NPPES files for 2008 on contain up to 50 other identifiers per NPI which can have any of the following types:

1 Other
2 Medicare UPIN
4 Medicare ID-Type Unspecified
5 Medicaid
6 Medicare Oscar/Certification
7 Medicare NSC
8 Medicare PIN

Jean Roth created the NPI to UPIN crosswalk below from the National Plan and Provider Enumeration System (NPPES) downloadable data file for greater ease of use. An NPI can and often does have more than one UPIN associated with it. The crosswalk includes identifiers of any stated type if they look like a UPIN. That is, if they begin with a letter followed by five digits.

One limitation this dataset is that the provider had to include their old UPIN on the NPI application in order for the UPIN to appear here.

Another limitation is that CMS stopped delivering the medicare other provider identifers in January 2018. The files here are based on the December 2017 delivery.

To keep only records for individuals, I suggest dropping records with upintype == 4 (Group UPIN) or entity == 2 (Entity is an Organization, not an Individual).

The upintype and pcredential variables may be helpful for identifying and keeping only providers of certain types.

UPIN types are the following:
1 "Medical Doctors (Medical Doctors and Doctors of Osteopathy) (Char 1 UPIN A-M)"
2 "Non-physician Practicioners (Such as Anesthesia Assistants, Physician Assistants, Clinical Nurse Practioners) (Char 1 UPIN P-S)"
3 "Other Doctors (Such as Chiropractors, Dentists, Podiatrists, and Optometrists) (Char 1 UPIN T-V)"
4 "Group UPIN UPIN (Char 1 UPIN W-Z)"

The pcredential variable contains the credential information (e.g. M.D., D.O.) from the NPI Application form.

Processed versions of the source NPPES data these files are made from and an NPI to state license crosswalk, an NPI to Medicare crosswalk and an NPI to Medicaid crosswalk are also available.

Updates and changes.

December 2017 -- Last delivery with fuller range of Medicare Other Provider Identifier Type Codes

Stata	SAS	CSV	Desc
npi2upinxw.dta	npi2upinxw.sas7bdat	npi2upin.csv	desc_npi2upin.txt
upin2npixw.dta	upin2npixw.sas7bdat	upin2npi.csv	desc_upin2npi.txt