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State of the National Provider Directory (v1.0)pdf · ~30 pages

The full white paper — pre-registered findings against the 2026-05-08 CMS NPD release. Printable.

2026-06-02 update — landscape becomes the front door, REAL Health audit framework publishedNEWweb · ~6 min read

Two coordinated releases: the homepage swaps to a Karpathy-style hierarchical treemap (548 cells, 6 audit dimensions, one per state × specialty) and a new policy brief maps every § 6220 obligation of the REAL Health Providers Act to the AINPI signal that measures it. The choropleth moves to /map.

2026-05-22 update — H40 published, one confirmed case, three SAM-NPI false positivesweb · ~7 min read

Sharpened H30a to per-(NPI, HCPCS, place-of-service) detail. Cross-audit surfaced 4 strict-post-exclusion candidates nationally; primary-source verification confirms 1 (Eduardo Miranda MD, LEIE-excluded 2015, $880K Medicare Part B in CY 2023) and reveals 3 SAM-NPI-join false positives. H42 null result honestly framed.

2026-05-14 update — claims-side cross-audit shippedweb · ~6 min read

8 new findings (H29-H36) link AINPI's directory cohort to Medicaid spending, Medicare Part B / Part D, Open Payments, DMEPOS, nursing-home ownership, and NDH completeness. Strict-post-exclusion attribution and the H35 Stage B PPEF cross-walk fix shipped this week.

2026-05-08 update — first comparable-release deltasweb · ~5 min read

CMS pushed a new NDH bulk export. Endpoint −73%, Location −61%, OrgAffiliation +147%; total 27.2M → 21.7M. SSN exposures 46 → 41 (CMS partially scrubbed). Organization NPI-duplicate excess 383K → 1.41M. Two source-side schema breaks AINPI caught.

May 2 update — H26, H27, and SMD-letter readinessweb · ~5 min read

Independent verification of the 2026-04-30 Washington Post SSN-exposure finding (63 confirmed in the April release), the VA payer-directory cross-reference, and the v0.4.0 high-risk cohort closing 3 of 4 § 455.436 federal database checks.

Virginia case study (worked example)web · ~10 min read

Worked example using public federal data. 42 CFR § 455.436 framework + Virginia-specific data quality (130K practitioners, 99.50% NPPES match, 4,090 deactivated-still-listed, 40.8% organization NPI duplicate rate) + the 131-NPI Virginia federally-excluded cohort + H26 4-payer cross-reference + Stage B roadmap.

Virginia federally-excluded cohort (CSV)UPDATEDcsv · 131 rows

The 131 VA-resident NPIs in the H23 critical bucket (LEIE or SAM excluded, score ≥ 1.5) with per-NPI verification URLs (LEIE / SAM / NPPES). Public file derived from public federal sources.

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