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provider tax id

prvdr_tax_id
provider·Updated Jun 12, 2026

Definition

ISO-11179 Definition

The federal tax identification number assigned to a healthcare provider or organization by the Internal Revenue Service, used in healthcare claims submission to identify the billing entity for reimbursement and tax reporting purposes. Provider tax ID encompasses both the Employer Identification Number for organizations and the Social Security Number for individual sole proprietor providers. CMS requires a valid tax ID on all Medicare and Medicaid claims for payment processing and 1099 tax reporting.

Healthcare data teams store prvdr_tax_id as VARCHAR(10) to accommodate both nine-digit EIN format and SSN format, implement masking controls to protect this sensitive identifier in non-production environments, and use it as a joining key between claims billing records and provider credentialing tables for payment integrity analytics.

Standard Abbreviation

prvdr_tax_id

Category

provider

Production DDL — DIM_PROVIDER

DIM_PROVIDER.sql
CREATE OR REPLACE TABLE DIM_PROVIDER (
    prvdr_key           INTEGER        NOT NULL  -- surrogate key,
    prvdr_npi           VARCHAR(10)              -- NPI number,
    prvdr_tin           VARCHAR(10)              -- tax ID number,
    prvdr_first_nm      VARCHAR(100)             -- first name,
    prvdr_last_nm       VARCHAR(100)             -- last name,
    prvdr_org_nm        VARCHAR(255)             -- organization name,
    prvdr_typ_cd        VARCHAR(20)              -- provider type code,
    prvdr_spclty_cd     VARCHAR(10)              -- specialty code,
    prvdr_tax           VARCHAR(10)              -- taxonomy code,
    prvdr_state_cd      CHAR(2)                  -- state code,
    prvdr_zip_cd        VARCHAR(10)              -- zip code,
    prvdr_ntwk_sts      VARCHAR(10)              -- network status,
    prvdr_accpt_pt_ind  CHAR(1)                  -- accepting patients,
    prvdr_excl_ind      CHAR(1)                  -- exclusion indicator,
    load_dt             TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical provider table. Convert to BigQuery or Databricks →

Why This Term Matters

Provider data management is one of the most operationally complex data domains in healthcare because providers move, merge, and update their credentials continuously. A data engineer who understands provider terminology can build NPI validation, credentialing, and network adequacy pipelines that keep provider directories accurate and prevent claim rejections. Stale or incorrect provider data is a leading cause of prior authorization delays and CMS compliance findings.

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