Overview
This enrichment transforms basic TIN identifiers into rich organizational profiles by:- TIN Type Classification: Determining if TINs are EINs, NPI Type 1, or NPI Type 2
- Entity Name Resolution: Finding official organization names through multiple data sources
- Organizational Attributes: Adding size, location, and specialty information
- Billing Capability Analysis: Determining if organizations can bill for specific services
Data Sources
The enrichment uses multiple reference data sources:- NPI Registry: National Provider Identifier database for TIN classification and provider information
- Healthcare Provider Taxonomy: Standard taxonomy codes and specialty classifications
- Historical CMS Claims Data: For determining service-specific billing capabilities
Output Schema
The enrichment produces 15 columns providing comprehensive organizational context:| Field | Description | Example |
|---|---|---|
entity_name | Primary display name for the healthcare entity | ”ABC Medical Group” |
tin | Original Tax Identification Number from rate data | ”12-3456789”, “1234567890” |
tin_type | Type of tax identifier (ein, npi1, npi2, unknown) | “ein”, “npi2” |
org_match_type | Method used to match organizational information | ”direct_match”, “npi2_imputed” |
org_name | Official organization name from authoritative sources | ”ABC Healthcare System” |
org_ein | Employer Identification Number of the organization | ”12-3456789” |
org_states | States where the organization operates | [“TX”, “OK”, “AR”] |
org_taxonomies | Healthcare specialty codes for the organization | [“207Q00000X”, “208D00000X”] |
org_taxonomy_names | Human-readable specialty names for organization | [“Family Medicine”, “General Practice”] |
org_est_count_md | Estimated count of physicians in organization | 45 |
org_est_count_app | Estimated count of advanced practice providers | 12 |
org_est_count_npi1 | Total estimated individual provider count | 67 |
taxonomy_names | Human-readable specialty names for rate-specific providers | [“Family Medicine”] |
can_bill | Organization can legitimately bill for this service | true, false |
Processing Logic
This enrichment answers key questions about the healthcare organizations behind each rate: “Who are they?” and “What do they actually do?” Identifying the OrganizationThe system examines provider identifiers to determine if they represent individual doctors, group practices, or large healthcare systems. When multiple identifiers point to the same organization (like different departments in a hospital), they’re grouped together to create a complete organizational profile. Understanding Their Business
For each organization, the system gathers important details like how many providers they have, what medical specialties they offer, and where they operate. This helps explain why their rates might be higher or lower than others. Determining Service Capabilities
The system also figures out what services each organization can realistically provide by looking at their specialties and past billing patterns. If an organization’s doctors have frequently performed a procedure, it’s marked as a service they can legitimately offer.