Specialist ranking update

Tiers: 1,169 Tier 1 · 3,946 Tier 2 · 1,755 Tier 3 · 2,692 policy-restricted.

These are provisional public-data network-fit tiers under the HPSN composite (base 40 + ownership, NPI tenure, credential and proximity). Medicare charge-efficiency, compatible PY2023 MIPS and ASC components were not assessed; a zero contribution is neutral, not adverse. The score range shows the sensitivity to those unassessed components. Ownership comes from the NPPES sole-proprietor flag and Medicare group names in the CMS clinician directory (October 2, 2026); groups named for a hospital system, corporate platform or telehealth service are policy-restricted. Each NPI was screened against the HHS-OIG LEIE exclusion file. This is not a clinical-quality ranking or board admission.