Methodology

Last reviewed: 2026-04-17. Data vintage: NPPES weekly snapshot 2026-04; Open Payments PY2023; Medicare Provider Utilization CY2022; PECOS 2026-04.

What Is DocTransparency?

DocTransparency is an independent journalism project that aggregates publicly available federal healthcare data into one readable profile per physician. Our goal is to make information that already exists — scattered across multiple government databases — easy to find and understand for patients, journalists, and researchers. We are expanding coverage state by state; currently: CA, FL, GA, IL, MA, MI, NC, NJ, NY, OH, PA, TX, WA, with nationwide expansion in progress.

DocTransparency is operated by Yoel Castaño as a sole proprietorship, pending formation of a US legal entity. We accept no funding from healthcare industry stakeholders, insurers, or pharmaceutical or medical device companies.

We do not generate or create any data. Everything on this site comes directly from federal sources published by the Centers for Medicare & Medicaid Services (CMS).

All data is published by the federal government as a matter of statutory mandate (Physician Payments Sunshine Act, §6002 of the Affordable Care Act, 42 U.S.C. §1320a-7h; HITECH Act provisions establishing the NPPES public registry) and is reproduced here under principles of newsgathering and public-interest journalism, including protections recognized in Bartnicki v. Vopper, 532 U.S. 514 (2001).

Important Notice

DocTransparency is for informational and journalistic purposes only. Nothing on this site is medical advice, a recommendation to choose or avoid any provider, an endorsement, or a quality rating. We do not establish a doctor-patient relationship. Always consult a licensed healthcare professional for medical decisions and verify all information with the provider directly before acting on it.

Data Sources

We draw from four distinct CMS datasets:

NPPES (National Plan and Provider Enumeration System) — The authoritative registry of all healthcare providers in the US. Contains provider names, credentials, specialties, practice addresses, and NPI numbers. Updated weekly by CMS; our snapshot dated 2026-04. Our database includes the full national registry; profile pages are currently generated for Texas and Florida. Download data.

Open Payments — CMS's implementation of the Physician Payments Sunshine Act. Records all financial transfers from pharmaceutical and medical device companies to physicians and teaching hospitals. Payment records are self-reported by pharmaceutical and medical device manufacturers under federal mandate; CMS provides a 45-day physician dispute window before publication, but does not independently audit each transaction. Published annually, covering the prior calendar year. Most recent year displayed: PY2023. Explore data.

Medicare Provider Utilization and Payment Data — Annual data showing which procedures Medicare providers performed, how many times, and what Medicare paid. Covers Part B (outpatient/physician services). Published with approximately a two-year lag; most recent year displayed: CY2022.

PECOS (Provider Enrollment & Certification System) — Tracks which providers are enrolled in Medicare and Medicaid programs and their enrollment status.

Data Coverage

Data Coverage measures data completeness, not quality of care. A higher level means more federal data exists for that provider across our four sources — it does not mean the provider is better or worse, more competent, or more recommendable. The highest level means we found data in all four datasets; the lowest means we found data in only one.

Each profile displays Data Coverage as a level (for example "Very High" or "Low"), derived from an internal 0–100 completeness score calculated as: (datasets with data present ÷ 4) × 100, with up to 5 additional points per dataset awarded for field completeness within that dataset (e.g. presence of payments breakdown, multiple procedure codes, or complete address). The full formula is published in our open-source repository.

Scoring model version

Data Coverage scoring model: v1.0.0 — active since 2026-06-20 (metric renamed and unified sitewide from the earlier "Transparency Score" label; formula unchanged from prior implementation).

Whenever the formula, weights, dataset set, or level thresholds change in a way that would move a real provider's Data Coverage level, we bump this version and add a dated entry in the methodology changelog explaining what changed and, when applicable, the count of profiles whose level moved. We commit to this so any comparison of Data Coverage across time is anchored to a version, not to an unstated moving target.

What the Data Covers and Doesn't Cover

This data covers Medicare patients only (generally age 65+ or patients with qualifying disabilities). It does not reflect a provider's full patient population, private insurance activity, Medicaid patients, or cash-pay patients. Providers who primarily treat younger or privately insured patients will appear to have lower Medicare volumes — this does not reflect their actual caseload, expertise, or patient outcomes.

Limitations

  • Medicare utilization data is published with approximately a two-year lag
  • Open Payments data covers calendar-year reporting periods; the most recent full year available is typically two years prior
  • Open Payments records are self-reported by manufacturers; we do not independently verify them
  • Suppressed records: CMS suppresses procedure counts below 11 to protect patient privacy
  • Provider addresses in NPPES reflect the address on file at registration and may be outdated; out-of-date addresses are common
  • Industry payment disclosure alone establishes neither wrongdoing, improper influence, nor legality
  • FL board action data is currently shown only for providers whose primary practice state is FL. Providers licensed in Florida who practice primarily in another state may have FL Board Action records that we do not surface, pending legal audit (see our internal decision log)

What We Don't Do (and Where to Look Instead)

To be honest about what this project is and isn't, here is how DocTransparency positions itself against the tools patients and journalists most often reach for. Naming other sites is not a criticism — each serves a different job. This is about setting expectations.

  • We are not a doctor-review site. We do not host patient reviews, star ratings, or subjective testimonials. If you want user reviews, see Healthgrades, Vitals, or Zocdoc. Their signal is patient sentiment; ours is federal record.
  • We are not a payments-only lookup. ProPublica's Dollars for Docs covered industry payments alone from 2010 until it was retired in 2019. Since then, no comparable independent tool has cross-referenced payments with Medicare practice, NPI status, and enrollment. That is the specific gap we fill: four federal datasets on one profile page, not payments in isolation.
  • We are not CMS Physician Compare (Care Compare). The official CMS site publishes quality measures at the practice level, participation flags, and specialty. It does not show Open Payments data alongside, does not aggregate the four datasets we use, and does not surface company-level payment breakdowns. For CMS-run quality measures, go to medicare.gov/care-compare. For an integrated view, come here.
  • We are not the FSMB / state medical boards. For license status, disciplinary history, and NPDB queries a patient is entitled to, the authoritative sources are the state licensing boards themselves and, for aggregated license lookup, DocInfo (FSMB). We surface Florida board-action data because it is publicly downloadable; we do not attempt to replicate the FSMB's licensing role for other states.
  • We are not an outcome or malpractice database. We publish neither malpractice history (that lives in the NPDB, non-public) nor clinical outcomes (there is no comprehensive federal source). Any tool claiming to score physicians on "quality" from federal billing data alone is guessing; we do not guess.
  • We do not score reputation. Our Data Coverage metric measures data completeness — how much federal information exists about a provider — nothing more. It is not a quality index, a reputation rank, or a recommendation. See the metric's definition above, its versioning, and its use in each profile.

What is unique to DocTransparency: procedure-level granularity by HCPCS code, four federal datasets integrated on one URL per physician, source citations traceable back to the CMS record, and a single named editor personally responsible for every methodology decision. That combination does not exist elsewhere at the time of writing.

Update Frequency

We refresh our data pipeline when CMS releases new annual datasets, typically in the second quarter of each year for the prior program year. NPPES is refreshed at least monthly. Each profile page displays the date of its underlying data snapshot.

Corrections and Removal Requests

If you are a provider and believe information on your profile is inaccurate, contact [email protected] with your NPI and the specific data point in question. We respond within 5 business days.

Profiles combine CMS public records with calculated summaries and explanatory labels. We can correct errors in those transformations. Corrections to the underlying federal record must also be filed with CMS (NPPES corrections via the NPI Registry; Open Payments disputes via the Open Payments physician portal). We will annotate or suppress on a case-by-case basis pending CMS update. Right-to-be-forgotten / opt-out requests are evaluated under our Privacy Policy.

Editorial responsibility: Methodology authored and maintained by Yoel Castaño, founder, DocTransparency. Questions: [email protected]. Last reviewed 2026-04-17.

Data Disclaimer — Data sourced from the Centers for Medicare & Medicaid Services (CMS): National Plan and Provider Enumeration System (NPPES), Open Payments program, Medicare Provider Utilization and Payment Data, and Provider Enrollment & Certification data (PECOS). Published under the Freedom of Information Act (FOIA). This website is not affiliated with, endorsed by, or authorized by CMS, HHS, or the U.S. Government. Data may contain errors as reported to CMS by providers and reporting entities. Industry payment disclosure alone establishes neither wrongdoing nor legality. Medicare data reflects only patients aged 65+ or those with qualifying disabilities. For corrections, contact CMS directly. This information does not constitute medical advice and should not be used as the sole basis for choosing a healthcare provider. Procedure descriptions use plain language and do not reference CPT® codes, which are copyrighted by the American Medical Association. Full methodology → · Report a data error → · Privacy policy →