Initial Physician Profile
An AMA Physician Profile (aka initial profile) provides comprehensive physician information, including education, training, board certifications, state license data and more. Initial profiles are often used by a health care organization to confirm physician-submitted information when applying for clinical privileges at that organization. It is also used by payers to validate physician information for reimbursement and/or provider enrollment.
Primary source verification requirements
The AMA verifies with the primary source the following elements:
- Medical school
- Graduate medical education
- ABMS® specialty board certification (includes MOC)
- All state licensure data (current and historic) and sanctions
- DEA registration
- National Provider Identifier (NPI) number
- Education Commission for Foreign Medical Graduates (ECFMG) applicant number
For a detailed explanation about these core elements and all other elements in an AMA Profile, click here.
The AMA Physician Masterfile—the source of AMA Physician Profile data—meets select primary source verification requirements of the following organizations:
- Centers for Medicare and Medicaid Services (CMS)
- The Joint Commission (TJC)
- Healthcare Facilities Accreditation Program (HFAP)
- DNV-GL Healthcare (DNV-GL)
- Accreditation Association for Ambulatory Health Care (AAAHC)
AMA is an official licensee of American Board of Medical Specialties (ABMS®) data. As such, the AMA is designated as an official ABMS display agent and serves as a provider of primary source equivalent ABMS specialty board certification data. That data, which is updated monthly, includes the following:
- Specialty and subspecialty certification (certification type)
- Initial year granted (effective date)
- Expiration dates
- Reverification dates
- Status (active or expired)
- Maintenance of certification
A summary of how data elements within AMA Profiles meet the standards of the accrediting bodies can be found here, including the AMA Masterfile data elements that the National Committee for Quality Assurance (NCQA) has approved as a source for verification.
Download an important file about the TJC's acceptance of AMA Physician Masterfile data.