Digital Contact Information FAQs

Digital Contact Information: What is it? What is required?

What is a digital contact? Where do providers find information on how to enter or update digital contact information associated with their National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES) and what fields are required to complete their entry for digital contact?

RESPONSE: . Digital contact information, also known as endpoints, provide a secure way for health care entities, including providers and hospitals, to send authenticated, encrypted health information directly to known, trusted recipients over the internet.[18] Health care organizations seeking to engage in electronic health information exchange need accurate information about the electronic addresses (for example, Direct address, FHIR server URL, query endpoint, or other digital contact information) of potential exchange partners to facilitate this information exchange. NPPES can now capture information about a wide range of endpoints that providers can use to facilitate secure exchange of health information (85 FR 25581).

Providers may find additional information on digital contact information in NPPES on the Health Information Exchange page of the NPPES website at: https://nppes.cms.hhs.gov/webhelp/nppeshelp/HEALTH%20INFORMATION%20EXCHANGE.html.

- In the CMS Interoperability and Patient Access final rule, CMS finalized the policy to publicly report the names and NPIs of those providers who do not have digital contact information included in the NPPES system beginning in the second half of 2020 (85 FR 25584).
- Instructions on how to update digital contact information in NPPES and what fields are required can be found in the instructional PowerPoint deck, beginning on slide 29, at: https://nppes.cms.hhs.gov/assets/How_to_apply_for_an_NPI_online.pdf. The required fields, shown on slide 30, are: Endpoint; Endpoint Type; Endpoint Location; Endpoint Affiliation; and the Endpoint Use Terms and Conditions checkbox.

Will patients or members of the public be able to contact a provider via a Direct address, since this information will be publicly available in NPPES?

RESPONSE: The main purpose of a Direct address is for providers to exchange health information with each other over the internet in a standardized, secure manner. In general, “Direct” is a technical standard for exchanging health information between health care organizations. Direct is similar to email, but different in important ways. For example, Direct messages are authenticated and encrypted in a specific way to ensure that data are sent and received only by authorized parties. Direct is also formatted slightly differently than personal email. There are some providers who use the Direct technology to communicate with their patients through their patient portals; however, the intent of this technology is not to serve as a regular email exchange for members of the public or patients. Direct addresses are available from a variety of sources, including electronic health record (EHR) vendors, State Health Information Exchange entities, regional and local Health Information Exchange entities, as well as private service providers offering Direct exchange capabilities called Health Information Service Providers (HISPs).

What is the deadline for compliance with the requirement that providers (or clinicians) enter their contact information into NPPES?

RESPONSE: In the CMS Interoperability and Patient Access final rule, CMS finalized the policy to publicly report the names and NPIs of those providers (or clinicians) who do not have digital contact information included in the NPPES system beginning in the second half of 2020 (85 FR 25584). CMS also noted that we would engage in public education efforts to ensure providers were aware of the benefits of including digital contact information in NPPES, including FHIR Application Programming Interfaces (API) endpoints, and when and where this information will be posted. Based on stakeholder inquiries, CMS decided to wait to publish the public report until the programming for the bulk upload of provider information was completed to allow larger organizations to complete the process of adding the digital contact information into NPPES in an efficient manner. The Electronic File Interchange (EFI) process now supports bulk upload capability which enables provider organizations to submit data element changes for their providers, including the addition of the digital contact information. CMS plans to publicly report providers with missing digital contact information by the end of 2021, to give all providers additional time to enter their digital contact information in NPPES, either individually or through the bulk upload. All EFI documents are available here: https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/efi.

- CMS has been responding to individual inquiries through the Health Informatics and Interoperability mail box or through the enumerator. This document serves as a public education tool for the wider stakeholder community.

Where will the list of providers (or clinicians) who do not have digital contact information in NPPES be posted?

RESPONSE: The list of providers who do not have digital contact information in NPPES will be available on data.cms.gov.

What types of providers (or clinicians) should add their digital contact information into NPPES?

RESPONSE: The types of providers and clinicians who should add their digital contact information into NPPES include those provider types listed below, who have, or may be eligible for a National Provider Identifier (NPI) number. Provider Type 1, or individual providers, as well as providers employed by Provider Type 2 health care organizations, are examples of those provider types who should enter digital contact information, including FHIR endpoints in NPPES. Providers and clinicians who should enter digital contact information in NPPES include:

- Physicians (including doctors of medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, and optometry)
- Osteopathic practitioners
- Chiropractors
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- Physical therapists
- Occupational therapists
- Clinical psychologists
- Pharmacists
- Qualified speech-language pathologists
- Qualified audiologists

Do hospital-based medical professionals need to have a digital contact listed in NPPES? Do these providers enter their own digital contact information, or may they use the hospitals digital contact information and enter that in NPPES?

RESPONSE: CMS’ policy of publicly reporting the names and NPIs of those providers who do not have digital contact information included in the NPPES system applies to individual providers and clinicians, regardless of their affiliation or employment with a hospital (85 FR 25584). NPPES can now maintain information about the type of contact information for providers or clinicians and the organizations with which they are associated, along with the preferred uses for each digital address. Each provider (or clinician) in NPPES can maintain their own unique digital contact information or associate themselves with information shared with a hospital or among a group of providers or clinicians. Hospital-based providers or clinicians are included in this policy of public reporting of missing digital contact information in NPPES. Providers or clinicians who work for hospitals or facilities may choose to use their own digital contact or that of the hospital or facility by whom they are employed. See other questions in this document about the bulk data upload process for large organizations, including hospitals.

If an individual provider or clinician practices at multiple hospitals, facilities or practice locations, can they enter multiple digital contact addresses in NPPES, associated with their NPI?

RESPONSE: Yes, NPPES allows providers or clinicians to add multiple digital contacts for multiple practice locations. Each endpoint listed by the provider should be associated with a practice location that is listed on the NPI record. Also, if the endpoint is associated with an organization, the provider clinician may add the organization information on the NPI record when adding the digital contact information

Bulk Upload, Reviewing and Updating Digital Contact Information in NPPES. - How does an organization update digital contact information for multiple providers, clinicians or medical professionals in one file or submit a bulk update for digital contact information?

RESPONSE: Large organizations with many providers or clinicians with NPIs who wish to conduct a bulk upload or update of provider digital contact information will be able to do so through the Electronic File Interchange (EFI) process. CMS has developed an enhancement that will allow for bulk updating of digital contact information in NPPES. The EFI process will allow only the digital contact information to be updated without impacting the rest of the record in NPPES, and no additional data fields will need to be updated for each individual provider or clinician. The bulk upload functionality is now operational in NPPES.

Where can a provider review and verify their digital contact information in NPPES?

RESPONSE: Information in NPPES is publicly accessible via both an online search option and a downloadable database option. Providers may review and confirm their digital contact information in several web locations, including: the NPPES NPI Registry at https://npiregistry.cms.hhs.gov, the NPPES NPI Registry API at https://npiregistry.cms.hhs.gov/registry/help-api, or the NPPES Data dissemination file at https://www.cms.gov/regulations-and-guidance/administrative-simplification/NationalProvIdentStand/DataDissemination . Each source currently contains all the information that will allow providers to determine the correctness of their information (85 FR 25583).

Is it possible for a provider practice to maintain one digital contact (e.g., DoctorOffice@direct.office.net) to accommodate the transfer of electronic health information for all of the practitioners providing services within the group, such that NPPES for each practitioner within the group, and the group’s NPI would reflect the same digital contact?

RESPONSE: Yes, it is possible for a provider practice to maintain one digital contact, however the practice may need to implement workflows to accommodate a process for accurately transferring electronic information to individual providers. For more information on how information is captured in NPPES, we encourage providers to review information available on the NPPES website at https://nppes.cms.hhs.gov/webhelp/nppeshelp/HEALTH%20INFORMATION%20EXCHANGE.html (85 FR 25584).

What should a provider enter in the digital contact field if their organization does not have the capability to exchange information electronically? Can they share information through fax?

RESPONSE: A digital fax number is not considered a digital endpoint (85 FR 25583). For those providers who continue to rely on the use of fax-based modes of sharing information, we hope that greater availability of digital contact information will help to reduce barriers to electronic communication with a wider set of providers with whom they share patients. Ubiquitous, public availability of digital contact information for all providers is a crucial step towards eliminating the use of fax machines for the exchange of health information (85 FR 25581). CMS urged all providers to take advantage of this resource to implement Congress’ requirement that the Secretary establish a digital contact information index. If a provider is not exchanging information electronically, and does not have a digital contact, the digital contact field would remain empty in their NPPES record, and they will appear on the public report of providers who do not have digital contact information in NPPES. The report will be updated once they have the capability to exchange electronically and update their digital contact information in NPPES (85 FR 25584).