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Credentialing Services
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AMA Meets Standards

The AMA has verified with the primary sources each of the credentials elements listed in the following tables.

 

AMA credentialing products and services measured 
against regulatory and accreditation standards 

 

AMA Physician Profile (MD and DO)  

Hospital Setting 

Managed Care Setting 

Ambulatory Setting 

Credentials Element 

Source 

CMS 

TJC* 

ACHC 

DNV 

CMS 

NCQA 

URAC 

AAAHC 

Licensure: Current State licensing board 

 

 

 

 

(1) 

(1) 

✓ 

 

Licensure: Historical State licensing board 

+ 

+ 

 

+ 

+ 

+ 

US education AAMC and osteopathic schools 

 

 

 

 

✓ 

 

✓ 

 

ACGME-accredited training ACGME-accredited programs 

 

 

 

 

✓ 

 

✓ 

 

ABMS board certification ABMS 

+ 

 

 

+ 

✓ 

 

✓ 

 

NPI number CMS NPPES 

+ 

+ 

+ 

+ 

+ 

+ 

DEA registration  DEA 

+ 

+ 

 

 

✓ 

 

✓ 

 

Controlled substance registration or controlled dangerous substance information—exclusive to AMA’s VeriCre™ Physician Profile State agencies 

Sanction 
alerts‡ 

Licensure: Current State licensing board 

+ 

 

 

 

 (1) 

(1) 

✓ 

+ § 

Licensure: Historical State licensing board 

+ 

 

(1) 

(1) 

✓ 

Medicare/Medicaid OIG 

+ 

+ 

 

+ 

 

 

✓ 

+ 

DEA DEA 

+ § 

System for Award Management—exclusive to AMA’s VeriCre™ Physician Profile SAM 

US Air Force, Army, Navy, DOD, and VA: Historical Respective military branch/agency 

ECFMG identification number ECFMG 

 AMA provides the number only. 
Contact ECFMG directly for verification. 

 

 

 

Continuous Monitoring Service of Physician Profiles 

Hospital Setting 

Managed Care Setting 

Ambulatory Setting 

Sections Monitored on an Ongoing Basis 

Update Notification Trigger 

CMS 

TJC* 

ACHC 

DNV 

CMS 

NCQA 

URAC 

AAAHC 

Sanction 
alerts 

Licensure: Current and historical  Alert from state licensing board 

+ 

+ 

+ 

+ 

 (1)  

 (1) 

✓ 

+ 

Medicare/Medicaid  Alert from OIG 

+ 

✓ 

✓ 

✓ 

DEA Alert from DEA 

Licensure  

Changes in: 

  • License number 
  • MD/DO 
  • Locale 
  • Date granted 
  • Expiration date 
  • Status 
  • License type 

✓ 

✓ 

✓  

✓  

NPI number 

Changes in: 

  • NPI number 
  • Replacement number 

DEA registration  

Changes in: 

  • DEA number 
  • Business activity 
  • Drug schedule 
  • Activity 
  • Expiration date 

✓ 

ABMS board certification 

Changes in: 

  • Certifying board 
  • Certificate 
  • Certificate type 
  • Duration 
  • Effective date 
  • Expiration date 

ACGME-accredited training 

Changes in: 

  • Sponsoring institution 
  • Specialty 
  • Dates 

US education 

Changes in: 

  • School name 
  • Degree awarded 
  • Degree year 

+ 

Information current as of Sep. 10, 2024. ©2024 American Medical Association. All rights reserved. 

 

Symbols/indicators 

= meets standards 

+ = exceeds standards through higher level of compliance or industry leading practice 

(1) NCQA and CMS for Medicare Advantage require primary source verification of license directly with the licensing board and license sanctions directly with the licensing board or other recognized source. 

 

Notes 

* The Joint Commission accreditation standards deem the AMA Physician Professional Data™, formerly AMA Physician Masterfile, which populates AMA Physician Profiles, as a designated equivalent source for physician medical school, postgraduate medical training, and (due to its official ABMS display agent status) ABMS board certification. All other primary-source-reported information on the AMA Physician Profile meets and exceeds TJC principles for a credentials verification organization. See the AMA response to TJC CVO requirements

† ACHC requires primary source verification of licensure from state licensing agencies but additionally requires a query of the National Practitioner Data Bank and of the Federation of State Medical Boards or the Fraud and Abuse Control Information System. 

‡ Sanction Alerts: AMA provides notification only of sanctions in the profile’s “Action Notifications” section. Contact the primary source directly for sanction details. 

§ The AMA Profile exceeds accreditation standards if the organization’s bylaws and/or policies and procedures do not require verification of this data element. In instances when the organization requires verification, the AMA Profile meets accreditation standards. 

 

Acronyms 
AAAHC = Accreditation Association for Ambulatory Health Care, Inc., AAMC = Association of American Medical Colleges, ABMS = American Board of Medical Specialties, ACHC = Accreditation Commission for Health Care, ACGME = Accreditation Council for Graduate Medical Education, AMA = American Medical Association, CMS for hospital setting = Centers for Medicare & Medicaid Services: Conditions of Participation for Hospitals, CMS for managed care setting = Centers for Medicare & Medicaid Services: Medicare Advantage, DEA = Drug Enforcement Administration, DNV = DNV Healthcare, DOD = Department of Defense, ECFMG = Educational Commission for Foreign Medical Graduates, HFAP = Healthcare Facilities Accreditation Program, NCQA = National Committee for Quality Assurance, NPPES = National Plan and Provider Enumeration System, OIG = Office of Inspector General, SAM = System for Award Management , TJC = The Joint Commission, VA = Veterans Administration 

Disclaimer 

This publication is for informational purposes only. The AMA has consulted authors and editors believed to be knowledgeable in their fields to produce this publication. However, the AMA encourages readers to consult their own professional advisors or the accrediting bodies. The AMA disclaims all warranties and liability for this content.