PECOS Data for Sales Prospecting: What It Tells You That NPI Doesn't
PECOS is the Medicare enrollment system. It contains provider data that NPI doesn't, and almost nobody in B2B sales is using it.
Updated February 2026
What PECOS Is and Why Sales Teams Should Care
PECOS stands for the Provider Enrollment, Chain, and Ownership System. It is the system that CMS (Centers for Medicare & Medicaid Services) uses to manage the enrollment of providers and suppliers in the Medicare program. Every provider who bills Medicare must be enrolled in PECOS. Every organization that employs providers who bill Medicare must be enrolled. Every supplier of durable medical equipment, prosthetics, and orthotics (DMEPOS) must be enrolled.
PECOS is not the same as the NPI Registry. The NPI Registry (NPPES) assigns a unique identifier to every healthcare provider in the U.S. regardless of whether they participate in Medicare. PECOS tracks which of those providers are actively enrolled in Medicare and the details of their enrollment. A provider can have an NPI number without being enrolled in PECOS (if they do not bill Medicare). Conversely, every provider in PECOS has an NPI number, which makes PECOS data joinable to NPI data.
Why this matters for sales. PECOS contains data fields that the NPI Registry does not. These fields tell you about a provider's practice arrangements, organizational affiliations, and Medicare billing relationships in ways that are directly useful for B2B sales targeting. Most B2B healthcare sales teams know about the NPI Registry. Almost none are using PECOS data. This creates an information advantage for those who do.
What PECOS data is available publicly. CMS publishes several PECOS-derived datasets on the CMS data portal, including the Medicare Provider and Supplier Enrollment dataset, the Opt-Out Affidavits file, and the Order and Referring Supplier dataset. The National Bureau of Economic Research (NBER) hosts formatted extracts that are easier to work with. All of this data is free. The challenge is knowing what to do with it.
Important caveat. PECOS is a Medicare-specific view. Providers who do not participate in Medicare (cash-only practices, concierge providers) will not appear. For most B2B use cases, this gap is manageable because the vast majority of providers participate in Medicare.
What PECOS Data Contains Beyond NPI
The NPI Registry tells you who a provider is: name, NPI number, taxonomy code (specialty), and a single practice address. PECOS tells you how a provider practices within the Medicare system. Here are the data fields that matter for sales.
Medicare enrollment status. PECOS shows whether a provider is actively enrolled in Medicare, has had their enrollment revoked, or has opted out. Active enrollment is the baseline expectation, but the exceptions are informative. A provider who has opted out of Medicare has made a deliberate business decision to operate outside the Medicare system. This tells you something about their practice model (likely concierge or cash-based) and their patient demographics (fewer elderly patients). If you sell a product that depends on Medicare reimbursement, opted-out providers are not your market.
Reassignment data (billing relationships). When a physician "reassigns" their Medicare billing rights to an organization, that organization bills Medicare on their behalf. The reassignment data shows which individual providers are linked to which organizational providers. This is effectively a map of employment and contractual relationships. If Dr. Smith has reassigned billing to ABC Medical Group, Dr. Smith practices at ABC Medical Group. This lets you build organizational rosters without relying on self-reported information.
Practice affiliations. PECOS reveals which providers are affiliated with which practice locations. A provider may have multiple affiliations, indicating they practice at multiple locations. For territory planning, this tells you which surgeons operate at which ASCs and hospitals.
Specialty designations. PECOS uses Medicare specialty codes, a different classification than NPI taxonomy. Comparing NPI taxonomy to PECOS specialty can resolve ambiguities about what a provider actually does.
Organizational data. PECOS tracks organizational enrollments separately. Records include the organization's legal name, doing-business-as name, practice locations, organizational NPI, and affiliated individual providers. This gives you a structured view of medical groups and practice organizations more reliable than web scraping or directories.
Enrollment and revalidation dates. PECOS records when a provider first enrolled in Medicare and when they last revalidated their enrollment. New enrollments can signal new practice openings. Revalidation dates indicate active, current participation. Providers who have not revalidated may be winding down their practice.
How to Access and Work With PECOS Data
PECOS data is publicly available, but it is not user-friendly. Accessing it requires downloading bulk files, understanding the file formats, and joining tables to extract useful information.
CMS data.cms.gov downloads. The primary source is the CMS data portal. Search for "Medicare Provider and Supplier" datasets. The enrollment file contains individual and organizational provider records with enrollment status, specialty, and practice location. The file is a CSV download, typically several hundred megabytes. You can preview it in the portal's browser interface, but for real analysis you will need to download and process it locally.
NBER formatted files. The National Bureau of Economic Research hosts PECOS extracts in Stata and CSV formats with better documentation than the raw CMS files. These include the base enrollment file, the reassignment file (linking individuals to organizations), and the practice location file. The NBER files are the most practical starting point because they are already structured and documented.
Medicare Opt-Out file. CMS publishes a separate file listing providers who have opted out of Medicare. This is a small file (tens of thousands of records) useful for filtering your target lists. Available directly from the CMS Opt-Out page.
Working with the data. PECOS files are large but manageable with pandas or SQLite. The key join field is the NPI number. A typical workflow: load the individual enrollment file, join to the reassignment file to map individuals to organizations, then join to the practice location file for addresses. Filter by specialty, state, or enrollment status to narrow to your target universe.
Update frequency. CMS updates PECOS-derived datasets periodically, but not on a predictable weekly schedule like NPPES. Some files are updated monthly; others quarterly. The data can lag real-world changes by weeks to months. This lag is a meaningful limitation for time-sensitive prospecting and is one reason to supplement PECOS with commercial data sources that update more frequently.
Practical tip. If you are not comfortable working with large data files, you do not need to process PECOS yourself. Most commercial provider data platforms incorporate PECOS intelligence. The value of understanding PECOS directly is knowing what questions to ask your data vendor and validating the data they provide.
Limitations of PECOS Data for Sales Prospecting
PECOS data is a powerful supplement to your provider intelligence, but it has clear limitations that you should understand before relying on it.
No contact information. PECOS does not include email addresses, phone numbers, or direct contact information. It provides practice addresses from the enrollment form, which are often billing addresses rather than physical locations. For outreach-ready contact data, you need a commercial source. See our physician prospect list guide.
Medicare-only view. PECOS covers only Medicare-enrolled providers. While roughly 95% of non-federal physicians accept Medicare, it excludes concierge practices, some aesthetics providers, and some younger physicians who have not yet enrolled.
Update lag. PECOS public files are not updated in real-time. A provider who enrolled last month may not appear for weeks. A retired provider may remain with an active status for some time. Do not treat PECOS as a real-time source of truth.
Bulk data requires processing skills. Unlike the NPI Registry's web lookup tool, PECOS data is only available in bulk. The PECOS online portal is designed for providers managing their own enrollment, not for data consumers. For single-provider lookups, the Medicare Care Compare tool on medicare.gov is more practical.
Reassignment data can be stale. Relationships in the reassignment file may lag actual employment changes by months. Cross-reference with other sources to validate organizational affiliations.
No financial or volume data. PECOS covers enrollment status and relationships, not practice size, revenue, or procedure volume. For those data points, you need CMS utilization datasets or commercial vendors.
Combining PECOS + NPI + Commercial Data for a Complete Provider Profile
The real power of PECOS data emerges when you combine it with NPI data and commercial provider data. Each source fills gaps that the others leave.
NPI provides the identity layer. The NPI Registry tells you who the provider is: full legal name, NPI number, primary taxonomy code (specialty), a practice address, and whether they are an individual or organization. This is your base record. Every other data source joins through the NPI number. See our NPI Registry guide for details on what NPI data contains.
PECOS provides the relationship and enrollment layer. PECOS tells you how that provider operates: Are they enrolled in Medicare? Which organizations do they bill through? Where are their practice affiliations? What is their Medicare specialty designation? By joining PECOS reassignment data to NPI records, you can build organizational rosters. You know which physicians are at which medical groups, even if neither the NPI Registry nor the practice's website makes that clear.
Commercial data provides the contact and intelligence layer. Commercial provider data from vendors like Provyx adds what public data lacks: verified email addresses, direct phone numbers, technology installations, practice firmographics (size, revenue estimates, ownership structure), and regularly refreshed contact data. This is the layer that makes the data actionable for outreach.
A practical example. Suppose you sell practice management software and want to target multi-physician primary care groups in Texas. Start with NPI: pull all individual NPIs in Texas with a primary care taxonomy code. Layer in PECOS: use the reassignment file to group those individuals into the organizations they bill through. Now you know which medical groups have 5, 10, or 20 primary care physicians. Filter to groups with 5+ physicians (your ICP). Add commercial data: pull verified contact data for the office manager or practice administrator at each group, plus the technology stack (current practice management system) from Provyx. The result is a targeted, enriched list that no single data source could have produced alone.
Building the combined dataset. The technical approach: download NPPES weekly data extract, download PECOS enrollment and reassignment files from NBER or CMS, and join on NPI number. Add commercial data through a provider data API or bulk enrichment service. Store the combined dataset in a database or CRM. Refresh NPPES data weekly, PECOS data monthly, and commercial data on the cadence your vendor supports. For teams without data engineering resources, Provyx's custom list building service can deliver pre-built lists that incorporate these public sources alongside our proprietary contact data.
For more on how public and commercial data sources compare, see our guide on NPPES vs. commercial provider data.
Practical Use Cases: PECOS Data in Your Sales Workflow
Here are five specific ways B2B healthcare sales teams can use PECOS data to improve targeting and prospecting.
1. Building organizational rosters from reassignment data. If you sell to medical groups and need to know which physicians are part of which group, PECOS reassignment data is the most authoritative public source. Pull the reassignment file, filter to your target geography and specialty, and group individual NPIs by their organizational NPI. Compare this to your CRM to identify physicians you were not tracking. This is especially useful for large, multi-location groups where practice websites may not list all affiliated providers.
2. Identifying new Medicare enrollments. When a provider newly enrolls in PECOS, it often signals a new practice opening or a recent fellowship graduate entering practice. By comparing PECOS snapshots month-over-month, you can identify new enrollments in your target specialties and geographies. New providers are high-value prospects because they are actively making purchasing decisions and have not yet committed to vendor relationships.
3. Filtering out opted-out providers. If your product requires Medicare billing or Medicare patient volume, opted-out providers are not your market. The CMS Opt-Out file lets you remove these providers from your target lists. Conversely, if you sell concierge medicine technology or cash-pay practice tools, the Opt-Out list is your prospect list.
4. Validating organizational affiliations. CRM data about provider affiliations decays fast. A physician listed at ABC Medical Group may have moved to XYZ Health six months ago. PECOS reassignment data provides a secondary validation source. Cross-referencing helps you catch affiliation changes before you show up at the wrong office. Provyx's NPI data enrichment can automate this cross-referencing.
5. Identifying multi-site providers. PECOS practice location data shows when a provider is affiliated with multiple locations. A surgeon who operates at three ASCs is a different profile than one at a single hospital. Multi-site providers may have more influence and more complexity in how you engage them.
The bottom line on PECOS. PECOS data is free, authoritative, and underused by sales teams. Its limitations are real but manageable when combined with NPI data and commercial sources. For most teams, the practical path is to work with a provider data vendor who incorporates PECOS data rather than processing the raw files yourself.
Frequently Asked Questions
Is PECOS data free to access?
Yes. CMS publishes PECOS-derived datasets on data.cms.gov at no cost. The NBER also hosts formatted PECOS extracts for free. There is no registration or licensing requirement. The data is public. The challenge is that it is only available in bulk file format, which requires data processing skills to use effectively.
What is the difference between PECOS and NPPES?
NPPES (National Plan and Provider Enumeration System) assigns NPI numbers and maintains a registry of all healthcare providers. PECOS manages Medicare enrollment specifically. A provider can have an NPI without being in PECOS (if they do not bill Medicare). PECOS includes data that NPPES does not: Medicare enrollment status, billing reassignment relationships, and organizational affiliation details. Both use NPI as the key identifier, making them joinable.
How often is PECOS data updated?
CMS updates PECOS public files periodically, but the schedule varies by dataset. Some files are updated monthly, others quarterly. The data can lag real-world changes by weeks to months. For comparison, NPPES is updated weekly. If you need the most current enrollment status for a specific provider, the Medicare Care Compare tool on medicare.gov may be more current than the bulk files.
Can I look up a single provider in PECOS?
Not directly through a public PECOS portal. The PECOS online system is designed for providers managing their own enrollment. For individual provider lookups, use Medicare Care Compare on medicare.gov or the NPI Registry lookup tool (which covers NPI data but not PECOS-specific fields). For bulk analysis, download the PECOS files from data.cms.gov or NBER.
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