NPI HCP Match Rules

Learn about identifying duplicate healthcare professional records.

NPI HCP match rules help in identifying duplicate healthcare professional records. It lists duplicate records as suspect matches. The match rule names must match in the DTSS subscription.

Reltio has defined the following NPI HCP match rules for matching the healthcare professionals profiles.

  • PersonByNPI

    The PersonByNPI rule indicates that all healthcare professionals that have the exact Identifier Type that is NPI and exactly the same Identifier Value that is State License Number, are suspect matches/potential records/duplicate records.

    Table 1. Attributes
    Attribute Name Value
    First Name  
    Last Name  
    Credentials  
    Address Line 1  
    Premise  
    Street  
    Zip5  
    Identifier ID Exact
    State License Number EE(NPI)
    State License State  
  • PersonByExactNameAddressLine1Zip5

    The PersonByExactNameAddressLine1Zip5 rule indicates that all healthcare professionals that have the exact First Name, Last Name, Address Line 1, and Zip5, are suspect matches/potential records/duplicate records.

    Table 2. Attributes
    Attribute Name Value
    First Name Exact
    Last Name Exact
    Credentials  
    Address Line 1 Exact
    Premise  
    Street  
    Zip5 Exact
    Identifier ID  
    State License Number  
    State License State  
  • PersonbyExactNameNestedAddressLine1Zip5

    The PersonbyExactNameNestedAddressLine1Zip5 rule indicates that all healthcare professionals that have the exact First Name, Last Name, Address Type, Address Line 1, and Zip5, are suspect matches/potential records/duplicate records.

    In this match rule, the address attributes are from nested address that is "Addresses".

    Table 3. Attributes
    Attribute Name Value
    First Name Exact
    Last Name Exact
    Credentials  
    Address Type Exact
    Address Line 1 Exact
    Premise  
    Street  
    Zip5 Exact
    Identifier ID  
    State License Number  
    State License State  
  • PersonByExactNameAndExactPremiseStreetZip5Credentials

    The PersonByExactNameAndExactPremiseStreetZip5Credentials rule indicates that all healthcare professionals that have the exact First Name, Last Name, Premise, Street, and Zip5, and either exact or null (EON) Credentials, are suspect matches/potential records/duplicate records.

    Table 4. Attributes
    Attribute Name Value
    First Name Exact
    Last Name Exact
    Credentials EON
    Address Line 1  
    Premise Exact
    Street Exact
    Zip5 Exact
    Identifier ID  
    State License Number  
    State License State  
  • PersonbyExactNameAndExactPremiseStreetNestedZip5Credentials

    The PersonbyExactNameAndExactPremiseStreetNestedZip5Credentials rule indicates that all healthcare professionals that have the exact First Name, Last Name, Premise, Street, Address Type, and Zip5, and either exact or null (EON) Credentials, are suspect matches/potential records/duplicate records.

    In this match rule, the address attributes are from nested address that is "Addresses".

    Table 5. Attributes
    Attribute Name Value
    First Name Exact
    Last Name Exact
    Credentials EON
    Address Type Exact
    Address Line 1  
    Premise Exact
    Street Exact
    Zip5 Exact
    Identifier ID  
    State License Number  
    State License State  
  • PersonByFuzzyNameAndNPI

    The PersonByFuzzyNameAndNPI rule indicates that all healthcare professionals that have the fuzzy First Name and Last Name, but exact Identifier Type that is NPI, and exactly the same Identifier Value that is State License Number, are suspect matches/potential records/duplicate records.

    Table 6. Attributes
    Attribute Name Value
    First Name Fuzzy
    Last Name Fuzzy
    Credentials  
    Address Line 1  
    Premise  
    Street  
    Zip5  
    Identifier ID Exact
    State License Number EE(NPI)
    State License State  
  • PersonByFuzzyNameAddressAndExactZip

    The PersonByFuzzyNameAddressAndExactZip rule indicates that all healthcare professionals that have the fuzzy First Name, Last Name, and Address Line, but exact Zip5, are suspect matches/potential records/duplicate records.

    Table 7. Attributes
    Attribute Name Value
    First Name Fuzzy
    Last Name Fuzzy
    Credentials  
    Address Line 1 Fuzzy
    Premise  
    Street  
    Zip5 Exact
    Identifier ID  
    State License Number  
    State License State  
  • PersonByFuzzyNameNestedAddressAndExactZip

    The PersonByFuzzyNameNestedAddressAndExactZip rule indicates that all healthcare professionals that have the fuzzy First Name, Last Name, and Address Line, but exact Zip5, and Address Type are suspect matches/potential records/duplicate records.

    In this match rule, the address attributes are from nested address that is "Addresses".

    Table 8. Attributes
    Attribute Name Value
    First Name Fuzzy
    Last Name Fuzzy
    Credentials  
    Address Type Exact
    Address Line 1 Fuzzy
    Premise  
    Street  
    Zip5 Exact
    Identifier ID  
    State License Number  
    State License State  
  • PersonByStateLicense

    The PersonByStateLicense rule indicates that all healthcare professionals that have the fuzzy First Name and Last Name, but exact State License Number and State License State, are suspect matches/potential records/duplicate records.

    Table 9. Attributes
    Attribute Name Value
    First Name Fuzzy
    Last Name Fuzzy
    Credentials  
    Address Line 1  
    Premise  
    Street  
    Zip5  
    Identifier ID  
    State License Number Exact
    State License State Exact