Data Element: | Provider ID Code PV034 - June 7, 2013 - v3.1
(Massachusetts) |
Provider ID Code PV034 - October 1, 2014 - v4.0
(Massachusetts) |
ProviderIDCode PV034 - December 1, 2010 - v2.1
(Massachusetts) |
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Data Element ID | PV034 | PV034 | PV034 |
Definition | Provider Identification Code | Provider Identification Code | Provider Identification Code |
State / Source | Massachusetts |
Massachusetts |
Massachusetts |
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Lookup Table - Integer | Lookup Table - Integer | Text |
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tlkpEntityQualifierCode | tlkpEntityQualifierCode | Lookup Table |
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int[1] | int[1] | tlkpEntityQualifierCode |
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1 | 1 | 5 |
Column | 34 | 34 | 34 |
Threshold | 1 | 1 | 1 |
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No | ||
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All | ||
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Not Supplied | Not Supplied | 1 |
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A0 | A0 | Not Supplied |
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All | All | Not Supplied |
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Not Supplied | Not Supplied | '6/24/2010 |
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Report the value that defines type of entity associated with PV002. The value reported here drives intake edits for quality purposes. EXAMPLE: 1 = Person; Physician, Clinician, Orthodontist, etc. | Report the value that defines type of entity associated with PV002. The value reported here drives intake edits for quality purposes. EXAMPLE: 1 = Person; Physician, Clinician, Orthodontist, etc. | This field describes the type of entity that was submitted for this record (PV002). The DHCFP will provide a lookup table of eligible values with the carrier submission guide. |
File | PV | PV | PV |
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Not Supplied | Not Supplied | 5 |
Data Element: | Provider ID Code PV034 - June 7, 2013 - v3.1
(Massachusetts) |
Provider ID Code PV034 - October 1, 2014 - v4.0
(Massachusetts) |
ProviderIDCode PV034 - December 1, 2010 - v2.1
(Massachusetts) |
---|---|---|---|
0 | Other; any type of entity not otherwise defined that performs health care services. | Other; any type of entity not otherwise defined that performs health care services. | Other; any type of entity not otherwise defined that performs health care services. |
1 | Person; physician, clinician, orthodontist, and any individual that is licensed/certified to perform health care services. | Person; physician, clinician, orthodontist, and any individual that is licensed/certified to perform health care services. | Person; physician, clinician, orthodontist, and any individual that is licensed/certified to perform health care services. |
2 | Facility; hospital, health center, long term care, rehabilitation and any building that is licensed to transact health care services. | Facility; hospital, health center, long term care, rehabilitation and any building that is licensed to transact health care services. | Facility; hospital, health center, long term care, rehabilitation and any building that is licensed to transact health care services. |
3 | Professional Group; collection of licensed/certified health care professionals that are practicing health care services under the same entity name and Federal Tax Identification Number. | Professional Group; collection of licensed/certified health care professionals that are practicing health care services under the same entity name and Federal Tax Identification Number. | Professional Group; collection of licensed/certified health care professionals that are practicing health care services under the same entity name and Federal Tax Identification Number. |
4 | Retail Site; brick-and-mortar licensed/certified place of transaction that is not solely a health care entity, i.e., pharmacies, independent laboratories, vision services. | Retail Site; brick-and-mortar licensed/certified place of transaction that is not solely a health care entity, i.e., pharmacies, independent laboratories, vision services. | Retail Site; brick-and-mortar licensed/certified place of transaction that is not solely a health care entity, i.e., pharmacies, independent laboratories, vision services. |
5 | E-Site; internet-based order/logistic system of health care services, typically in the form of durable medical equipment, pharmacy or vision services. Address assigned should be the address of the company delivering services or order fulfillment. | E-Site; internet-based order/logistic system of health care services, typically in the form of durable medical equipment, pharmacy or vision services. Address assigned should be the address of the company delivering services or order fulfillment. | E-Site; internet-based order/logistic system of health care services, typically in the form of durable medical equipment, pharmacy or vision services. Address assigned should be the address of the company delivering services or order fulfillment. |
6 | Financial Parent; financial governing body that does not perform health care services itself but directs and finances health care service entities, usually through a Board of Directors. | Financial Parent; financial governing body that does not perform health care services itself but directs and finances health care service entities, usually through a Board of Directors. | Financial Parent; financial governing body that does not perform health care services itself but directs and finances health care service entities, usually through a Board of Directors. |
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Transportation; any form of transport that conveys a patient to/from a healthcare provider. | Transportation; any form of transport that conveys a patient to/from a healthcare provider. | Transportation; any form of transport that conveys a patient to/from a healthcare provider |