National Practitioner Data Bank

The full name for the NPDB — a federal repository of adverse action and malpractice payment reports for healthcare practitioners, used by payers and hospitals during credentialing.

The National Practitioner Data Bank is the federal database where adverse actions and malpractice payments involving healthcare providers are reported and stored. It was established in 1990 and is maintained by the Health Resources and Services Administration under the U.S. Department of Health and Human Services. Every payer and hospital checks the NPDB as part of the credentialing process. They run a query using your name, NPI, and other identifying information. The query returns any reports on file, including malpractice payments made on your behalf, adverse licensing actions, clinical privilege actions, professional society actions, DEA actions, and Medicare or Medicaid exclusions. Here is what catches many providers off guard: malpractice settlements get reported regardless of whether you were found at fault. If your insurance company settled a case to avoid the cost of litigation, that payment appears on your NPDB record. It does not mean you did anything wrong, but it is there and credentialing committees will see it. You cannot access other providers' NPDB records, but you can and should check your own. The NPDB Self-Query is available at npdb.hrsa.gov. Run a self-query before starting any credentialing process so you know exactly what payers will see. If there are reports on your record, prepare a written explanation before the credentialing committee asks for one. Having reports on your NPDB does not automatically disqualify you from network participation. Credentialing committees look at patterns and context. A single settlement from a decade ago in a high-risk specialty is very different from multiple claims in recent years. Be honest, be prepared, and provide context.