We cross-reference ten federal and state data sources to score provider directory validity across five dimensions.
All findings are derived exclusively from publicly available federal and state datasets and are fully traceable to their source records.
Data current as of March 12, 2026 (32d ago) · 41,940 providers scored
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41,940
Providers Evaluated
Across 13 Colorado carriers
~16%
Mixed Evidence
Cross-source signals incomplete or inconsistent
17
Compliance Violations
Federal exclusions or deactivated NPIs
~6.5k
Licensure Reconciliation
Difficult to reconcile against DORA records
15 federally excluded providers appear in active Colorado carrier networks.
All flagged records include traceable source evidence (OIG LEIE, SAM.gov, NPPES deactivation status).
View flagged providers →“Needs Review” reflects evidence availability across data sources, not provider quality. Providers are reclassified as additional sources are integrated.
Providers classified by verification status
Provider validity composed of five cross-source verification dimensions
0.75
Identity
NPI & NPPES verification
0.84
Licensure
DORA & PECOS enrollment
0.81
Activity
Medicare billing evidence
0.60
Reachability
Address consistency
0.85
Network
Cross-carrier network corroboration
Activity scores reflect evidence of recent patient care. Providers in DOI-submitted TiC files — with Section 6C-3 service minimums — score higher on this dimension than providers from federal filings alone. Additional sources such as CIVHC's Colorado All-Payer Claims Database would further strengthen verification across all carriers.
| Specialty | Providers | Avg Score | Flagged Providers | Review Rate |
|---|---|---|---|---|
| Pharmacy | 5 | 0.72 | 5 | 100.0% |
| Chiropractor / Optometrist | 5 | 0.64 | 5 | 100.0% |
| Genetic Counselor | 62 | 0.71 | 56 | 90.3% |
| Dietitian/Nutritionist | 366 | 0.72 | 322 | 88.0% |
| Behavioral Analyst | 659 | 0.69 | 563 | 85.4% |
| Nursing | 38 | 0.70 | 31 | 81.6% |
| Physician | 18 | 0.67 | 14 | 77.8% |
| Behavior Technician | 183 | 0.70 | 141 | 77.0% |
| Pharmacy | 13 | 0.71 | 9 | 69.2% |
| Clinical Lab Technologist | 9 | 0.67 | 6 | 66.7% |