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Credentialing Services
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Accrediting Body 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

 

Hospital Setting

Managed Care

AAAHC

Credentials Element

Source

CMS

TJC

HFAP

DNV GL

CMS

NCQA

Licensure: Current

State licensing board

(1)

(2)

(3)

(3)

Licensure: Historical

State licensing board

+

+

(1)

(2)

+

+

+

+

US education: MD/DO

AAMC

US post-graduate training: MD/DO

ACGME-accredited programs

ABMS board certification

ABMS

+

+

+

NPI number

CMS NPPES

+

+

(1)

+

+

+

+

+

DEA registration

DEA

+

+

(1)

SANCTION ALERTS*

Licensure: Current

State licensing board

+

(1)

(2)

(3)

(3)

+

Licensure: Historical

State licensing board

+

+

(1)

(2)

+

(3)

(3)

+

Medicare/Medicaid

OIG

+

+

(1)

+

+

ECFMG identification number

ECFMG

 

 

 

 

 

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

 

CONTINUOUS MONITORING SERVICE

 

Hospital Setting

Managed Care

AAAHC

Element Receiving Ongoing Monitoring

Source

CMS

TJC

HFAP

DNV GL

CMS

NCQA

SANCTION ALERTS*

Licensure: Current and historical

State licensing board

+

+

(1)

+

+

(3)

(3)

+

Medicare/Medicaid

OIG

+

+

(1)

+

+

+

Licensure

State licensing board

+

+

NPI number

CMS NPPES

+

+

+

+

+

+

+

DEA registration

DEA

+

+

+

+

+

ABMS board certification

ABMS

+

+

+

+

+

+

US post-graduate training: MD/DO

ACGME-accredited programs

+

+

+

+

+

+

+

US education: MD/DO

AAMC

+

+

+

+

+

+

+

Information current as of Dec. 1, 2020. ©2020 American Medical Association. All rights reserved.

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

Table Footnotes
* Sanction Alerts: AMA provides notification only of sanctions in the profile’s “Action Notifications” section. Contact the primary source directly for sanction details.
(1) Per The Joint Commission’s 10 credentials verification organization guidelines
(2) HFAP requires primary source verification of licensure 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.
(3) 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.

Acronyms
AAAHC = Accreditation Association for Ambulatory Health Care, Inc.
AAMC = Association of American Medical Colleges
ABMS = American Board of Medical Specialties
AMA = American Medical Association
AOA = American Osteopathic Association
CMS for hospital setting = Centers for Medicare & Medicaid Services: Conditions of Participation for Hospitals
CMS for managed care setting = Centers for Medicare and Medicaid Services: Medicare Advantage
DEA = Drug Enforcement Administration
DNV GL = DNV GL Healthcare
ECFMG = Educational Commission for Foreign Medical Graduates
HFAP = Healthcare Facilities Accreditation Program
NCQA = National Committee for Quality Assurance
OIG = Office of Inspector General
 

Download an important file about the TJC's acceptance of  AMA Physician Masterfile data.