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CMS PECOSCMS PECOS Medicare Provider Enrollment
U.S. Centers for Medicare and Medicaid Services · Tier-2 · profile-enrichment (renders on matched profiles)
CMS Provider Enrollment, Chain, and Ownership System (PECOS) publishes a monthly snapshot of providers actively enrolled in Medicare fee-for-service. A row in PECOS authorizes the provider to bill Medicare for the listed specialty + state.
How this source shows up on Fonteum.
We cross-reference NPPES-matched healthcare practices against PECOS to surface a Medicare-billing-active indicator on the profile, alongside the CMS provider type and enrollment state. The display module is gated to medical archetypes only.
What this source does NOT mean
Medicare enrollment records identify public CMS enrollment records; they do not indicate quality, outcomes, board certification, or appointment availability. Confirm Medicare assignment with the practice directly.
Research and data questions this source supports.
- Filter a provider directory to Medicare-billing-active practitioners — PECOS enrollment is the authoritative signal for Medicare billing eligibility.
- Validate that a provider's Medicare enrollment covers the specialty and state listed in your credentialing system.
- Identify providers whose Medicare enrollment has lapsed — PECOS rows drop when enrollment terminates, making absence a signal.
- Build a payer-network integrity check that cross-references PECOS enrollment dates against claim-submission windows.
- Support M&A diligence on medical practices by checking whether revenue-generating providers are currently enrolled and billing.
Dataset size: ~1.1 million active enrollments (monthly snapshot)
Per-field display contract.
Every field below has a `display_allowed` flag in the §94 provenance schema. Write-locked fields are captured to provenance for audit but never rendered on profile pages.
Renders on profile
3 fieldsWrite-locked — captured to provenance, not displayed
2 fieldsWhat we can’t infer from this source.
- PECOS reflects Medicare fee-for-service enrollment only — not Medicare Advantage panels or commercial-insurance contracts.
- Providers can be high-quality and not enrolled in Medicare. Absence in PECOS is not a negative quality signal.
- Providers can be enrolled with a temporarily-suspended billing status that the monthly snapshot does not reflect.
- PAC ID and Enrollment ID are CMS-internal identifiers; Fonteum captures them to provenance for audit but never renders them on profile pages.
Authority, license, refresh cadence.
Authority
U.S. Centers for Medicare and Medicaid Services
Tier
Tier-2 · profile-enrichment (renders on matched profiles)
Refresh cadence
Monthly — CMS publishes a fresh PECOS Public Provider Enrollment file each month.
License
U.S. government public-domain works (https://www.usa.gov/government-works). Free to use with attribution; explicit redistribution rights. License ↗
Attribution requirement
Source: CMS PECOS · Last checked {YYYY-MM-DD}
What the source allows.
Same public-domain works regime as NPPES (https://www.usa.gov/government-works). Bulk redistribution permitted with attribution. The monthly Public Provider Enrollment file is published as a downloadable CSV; Fonteum pulls the enrollment indicator + provider type + enrollment state only.
What a single field looks like in the graph.
A worked example. Every field surfaced from this source carries this shape of provenance line — source · last checked · display rule · confidence (when applicable).
Field
Medicare enrollment indicator
Sample value
Active
Provenance line
Source: CMS PECOS · Last checked 2026-04-22 · Display rule: render label "Active in Medicare fee-for-service" · Confidence: 1.0 (NPI exact-match)
Official API, bulk download, and Fonteum endpoints.
Common questions about CMS PECOS.
- What is CMS PECOS and what data does it contain?
- PECOS (Provider Enrollment, Chain, and Ownership System) is CMS's system for managing Medicare provider enrollment. The public PECOS Public Provider Enrollment file — also called the Fee-for-Service Public Provider Enrollment extract — contains a row for each provider actively enrolled in Medicare FFS, with NPI, CMS provider type, enrollment state, and practice location.
- How do I download the PECOS enrollment file?
- CMS publishes the PECOS FFS Public Provider Enrollment extract at data.cms.gov. The dataset is updated monthly. It is U.S. government public-domain data available as a CSV download at no cost. The canonical dataset URL is: data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/medicare-fee-for-service-public-provider-enrollment.
- What is the difference between NPPES and PECOS?
- NPPES identifies all HIPAA-covered providers — it assigns NPIs and records taxonomy codes and addresses. PECOS tracks active Medicare FFS enrollment — a provider must separately enroll in PECOS to bill Medicare. A provider can have an NPI in NPPES but not be enrolled in PECOS (e.g., providers who only bill commercial plans, or retired providers who never deactivated their NPI).
- How often does PECOS update?
- CMS publishes a fresh PECOS Public Provider Enrollment extract monthly. Fonteum's Inngest cron pulls the monthly file within 48 hours of publication and attests the SHA-256 hash to the provenance chain. Each displayed enrollment indicator carries the pull date inline.
- Does PECOS enrollment mean a provider accepts Medicare patients?
- Enrollment in PECOS means a provider is authorized to bill Medicare for the enrolled specialty and state — it is an administrative status, not a scheduling or patient-acceptance signal. Whether the provider is accepting new Medicare patients depends on the practice; that is not in the PECOS dataset.
Where this source already shows up.
Verticals where this source renders today
- dermatologists
- chiropractors
Related sources in the graph
- /sources → The full source library — every dataset Fonteum cites.
- /data-provenance → The provider graph — pipeline diagram, source-family clusters, field-level provenance examples, display rules.
- /methodology → Network-wide sourcing, refresh cadence, and corrections policy.
- /editorial-policy → Independence, sourcing, conflicts, corrections, retractions.