Who has Access to National Practitioner Data Bank (NPDB) Reports?

As you know, a myriad of disciplinary, malpractice-related, and other matters must be reported to the NPDB.  The number of matters that must be reported are daunting.  Here are just some of them.

List of Matters Reported (Partial)

• Medical malpractice payment information
• Licensure actions by boards of medical examiners
• Licensure and certification actions taken by states
• Adverse actions taken by health care entities against clinical privileges, including professional review actions taken by professional societies
• Negative actions or findings by peer review organizations or private accreditation entities
• Health care-related criminal convictions when reported by federal agencies or health plans
• Health care-related civil judgments when reported by federal agencies or health plans
• Exclusions from participating in federal or state health care programs when reported by federal agencies or health plans
• Other health care-related adjudicated actions or decisions when reported by federal agencies or health plans

Once a matter is reported, it spreads like a wildfire.  Here are some of the ways it spreads.

California Business & Professions Code section 3047

a) The board shall develop an interface with the National Practitioner Data Bank for the purpose of conducting inquiries on applicants for licensure, applicants for renewal of licensure, and current licensees.

(b) The board shall limit its inquiries to both of the following:

(1) Whether an applicant or current licensee has been subject to discipline.
(2) Whether an applicant or current licensee has been the subject of an action required to be reported to the National Practitioner Data Bank by federal law.

(c) On and after July 1, 2018, the board shall charge, in addition to the fees in Section 3152, an applicant for licensure and an applicant for renewal of licensure four dollars ($4) for the purposes of this section.

Proactive Disclosure Service (PDS)

The “Continuous Query” is a database function that feeds NPDB filings to entities that hire or credential physicians. It is a 24/7 system that provides information from the data bank database regarding adverse licensure, privileging, Medicare/Medicaid exclusions, civil and criminal convictions, and medical malpractice payments. The entity signs up and enrolls all associated practitioners and the feed is then automatic.

Mandatory Inquiries

Hospitals

Hospitals are mandated by federal law to query the NPDB. Every two years a hospital must request information from the NPDB for all physicians, dentists, and other health care practitioners who are on its medical staff or who hold clinical privileges at the hospital. They also must make the inquiry when privileges are first applied for. Residents or interns who are not members of medical staff escape this mandatory review.

Privilege Expansion

A request to expand or add privileges triggers a mandatory inquiry by the hospital.

Other Entities Having Access

Health Care Entities Other than Hospitals

Other health care entities can access the data bank when they are entering into employment and more generally affiliation relationships with a doctor.

Federal

Law enforcement including both state and federal.  Agencies including both federal and state agencies administering government health care programs, including private entities administering such programs under contract.

Notice Letter to a Physician from the NPDB - What Do You Do?

Here's what you need to know.  (Source NPDB Website)

1. Sign in to ID.me and verify your identity                                             The NPDB partners with ID.me to provide secure access to your report with multi-factor authentication, or MFA, and identity verification. If you have an ID.me account you can use it to access your report. Otherwise, select Create an ID.me account on the ID.me sign in page. You must then complete ID.me's process to verify your identity for the NPDB. Once that is complete, select the option to allow ID.me to share your information with XMS. This is required to connect your NPDB account to your ID.me account. Learn more about MFA and Identity Verification.
2. You may be required to complete additional steps for NPDB identity verification.
   If you have an ID.me account that has been identity verified with another agency, use that account to sign in to the NPDB. The NPDB may require ID.me to collect additional information to comply with our federal security requirements. In that case, please complete all requirements that are displayed when you sign in.
3. You will need information from the notification letter.
   You will need to enter the Account ID from your letter. If your letter has an Access Code, you may also need to enter it. If you do not have the letter, you can request a Self-Query to access your information.
4. After you sign in, verify your contact information.
   Review and verify your contact information. You can add another email address to receive NPDB notifications. After you verify your contact information you can view your report.

The NPDB had 1.9+ million reports as of December 2025.  It is the most powerful tool for hostile persons or entities to irreparably damage the career of physicians.

If you are reported to the NPDB or if this is even a possibility you need immediate legal help.  The physician lawyers at the Horowitz office represent doctors and protect medical careers and reputations.  Call for an initial consultation (925) 283-1863.