Medicare AdvantageAdministrativeMedium impact
Updating and Certifying Provider Data
Healthfirst·Provider Update
We identified it
Jun 20, 2026
Summary
Providers are legally required to keep their NPPES (National Plan and Provider Enumeration System) data current. CMS is encouraging Medicare Advantage Organizations to use NPPES for provider directory validation, which may reduce the frequency of directory update requests from plans.
Action Required
Immediately: Providers must log into NPPES and verify all practice information is current, including addresses, phone numbers, specialty certifications, and accepting patients status. Assign office manager to review NPPES data quarterly and update immediately when practice information changes. This will reduce administrative burden from Medicare Advantage plans requesting directory updates.