How To: Understand Your NPDB Continuous Query Consolidated Report

Summary

This article reviews the Continuous Query Consolidated Report from the NPDB. This report combines a summary page and full individual reports on a queried subject, including identification, enrollment, and report categories searched. If reports exist, detailed actions like licensure or malpractice are included with updates. Users must verify the subject and review the summary first, then review individual reports for current status and resolution. The data is confidential and protected by federal law. For more information about the NPDB itself, visit www.npdb.hrsa.gov. An example of the report is provided at the end of this article

Overview

When you run a query through our platform, we use the National Practitioner Data Bank (NPDB) Querying and Reporting XML Service (QRXS) on your behalf to generate a Continuous Query Consolidated Report. 

Note on confidentiality: NPDB information is maintained for restricted use under federal law (for example, Section 1921 of the Social Security Act and 45 CFR Part 60). It is confidential and may be used only for the purpose for which it was disclosed. Disclosing or using this information for other purposes is a violation of federal law.

What a Consolidated Report is

A Continuous Query Consolidated Report combines two things into a single document:

1. A summary page showing the subject, the enrollment details, and which report types were searched.
2. The full text of any individual reports the Data Bank has on file for that subject.

If the Data Bank holds no reports for a subject, the consolidated report will simply show "No Reports" across every category. If reports do exist, each one is appended in full.

Reading the summary page

Subject identification

The top of the report identifies the individual who was queried, including details such as name, any other names on file, gender, date of birth, address, professional school and graduation year, and a masked Social Security Number.

Always verify the subject. The NPDB advises that recipients confirm the individual identified in the report is, in fact, the person of interest before relying on it.

Continuous Query enrollment information

This section confirms the subject's enrollment status (for example, Enrolled), the enrollment start and end dates, and which statutes the query was run under (such as Title IV, Section 1921, and Section 1128E). It also lists the querying entity and the authorized submitter. Enrollment runs through the listed end date unless it is canceled by the entity beforehand.

Summary of reports on file

This is a checklist of every report category the Data Bank searched. Each category is marked either "No Reports" or "Yes, See Below." Categories searched typically include:

• Malpractice Payment Reports
• State Licensure Actions
• Exclusion or Debarment Actions
• Government Administrative Actions
• Clinical Privileges Actions
• Health Plan Actions
• Professional Society Actions
• Federal Licensure Actions
• Judgment or Conviction Reports
• Peer Review Organization Actions
• Legacy categories (Licensure, Clinical Privileges, and Society Membership Actions)

Any category marked "Yes, See Below" has one or more detailed reports included later in the document.

Reading an individual report

When a category contains results, a full report is included for each one. A single matter may appear as more than one linked report over time (for example, an Initial report followed by a Revision report that updates or resolves it). Each individual report generally contains the following sections.

Submitter and reporting entity

Identifies who submitted the report and the reporting organization, along with the report type — Initial (I), Revision (R), or other update types — and an internal vendor identifier.

Report details and contacts

Lists the contact information for the entity associated with the action, including the most recent ("Latest Contact") details and the status of the original reporting entity.

Reference information

Provides identifiers that tie reports together, such as the Document Control Number (DCN), the report type, original submit and recent change dates, and the statute the report is maintained under. For revisions, it also references the previous DCN and transaction type so you can trace the history of a matter.

A Notes field may include supplemental information submitted to the NPDB from sources other than the reporting entity. This supplemental data is intended to add context and is clearly disclaimed as not having come from the reporting entity itself.

Reported information

This is the substance of the action. Depending on the report type, it may include:

• Type of action (for example, a state licensure action)
• Basis for action and classification codes describing what occurred and how it was categorized
• The agency or program name
• Action taken and action effective dates
• Any monetary penalty, fine, or restitution amount
• Action length (for example, a defined period or "Indefinite")
• A narrative describing the underlying events in the agency's own words
• Whether the action was appealed or disputed, and any subject statement

A follow-up revision report uses these same fields to record an update — for instance, noting that the subject completed required terms and that a license was restored or reinstated.

How to use this report

Review the summary page first to see whether any category returned results. If everything reads "No Reports," there is nothing further on file for that subject. If a category shows "Yes, See Below," read the corresponding individual report(s) to understand the action, its current status, and whether it has been resolved. Because matters can evolve, check the most recent report in any linked series to confirm the latest status.