Healthcare Provider Verification — NPPES/NPI

alaudin burki · @alaudinburki

Verify US healthcare providers by NPI in CMS's official NPPES registry: status, specialty, taxonomy and practice address, for individuals and organisations.

About

Healthcare Provider Verification — NPPES/NPI

Credentialing services, insurance networks, and patients currently verify a healthcare provider's NPI (National Provider Identifier) status by hand, on CMS's own NPPES lookup. Free, public, keyless. This turns a name/NPI/organization search into a verified provider record: active status, specialty, and practice address.

Input

{ "providers": [{ "organizationName": "Mayo Clinic" }] }

Query by npi, organizationName, or firstName/lastName — one identifying field is required per entry; state is optional to narrow results.

Sample output

{
  "npi": "1881018208",
  "enumerationType": "NPI-2",
  "name": "MAYO CLINIC",
  "isOrganization": true,
  "status": "A",
  "isActive": true,
  "practiceCity": "ROCHESTER",
  "practiceState": "MN"
}

Typical uses

  • Credentialing / provider network verification — confirm an NPI is active and matches the claimed specialty before onboarding.
  • Insurance network validation — bulk-check a provider roster's NPI status.
  • Patient due diligence — verify a provider's credentials before a visit.
  • Fraud/compliance screening — a deactivated or mismatched NPI is a real signal worth investigating.

⚠️ Read before you act

  • Covers both individual (NPI-1) and organization (NPI-2) providers — isOrganization tells you which; a search by organization name naturally returns NPI-2 records, a name search returns NPI-1.
  • isActive reflects NPPES's own current status — deactivation isn't necessarily fraud; providers retire, close practices, or merge organizations. Treat it as a signal to investigate, not a verdict.
  • The practice address is the LOCATION address, not the mailing address, when both are on file — the one relevant to "where do they actually practice."

Related actors

  • Nonprofit Financial Lookup — the same official-registry-verification pattern, for nonprofit financial data instead of healthcare credentials.
  • Financial Complaint Monitor — another regulated-entity lookup, for CFPB financial company complaints.

Limitations

  • Healthcare Provider Verification reads only what its sources publish publicly. Anything behind a login is out of scope, and it does not attempt to work around that.
  • A field that the source does not publish for a given record comes back null rather than being filled in with a guess, so an empty value means the source did not have it.
  • Output quality is bounded by the source. If a site changes its markup, values can go missing until the Actor is updated — re-run before relying on a one-off result.
  • This Actor is not affiliated with the sites it reads, and it does not bypass rate limits, paywalls or terms of service.

Fields

FieldTypeWhat it holds
matchedQuerystring,nullThe query this row matched.
npistring,nullNational Provider Identifier.
enumerationTypestring,nullHow the identifier was assigned.
namestring,nullDisplay name as the source writes it.
isOrganizationboolean,nullWhether the address belongs to an organisation rather than a person.
statusstring,nullOutcome recorded for this row.
isActiveboolean,nullWhether the record is still active at the source.
credentialstring,nullCredential this row describes.
primarySpecialtystring,nullPrimary Specialty as recorded for this row.
licenseNumberstring,nullLicence number.
licenseStatestring,nullState that issued the licence.
practiceCitystring,nullCity where the practice is located.
practiceStatestring,nullState where the practice is located.
practicePhonestring,nullPhone number for the practice.
enumerationDatestring,nullDate the identifier was assigned.
lastUpdatedstring,nullISO 8601 timestamp of the last change seen.
verdictstring,nullThe Actor's conclusion for this row, stated in words.

Pricing

The price and any free trial are shown in the pricing panel on this page. Compute is billed from your prepaid Bytewells credits.

FAQ

What does Healthcare Provider Verification return?
Verify US healthcare providers by NPI in CMS's official NPPES registry: status, specialty, taxonomy and practice address, for individuals and organisations.
Do I need an API key or an account elsewhere?
No. It reads CMS's free public NPPES registry.
How am I billed?
The price and any free trial are shown in the pricing panel on this page. Compute is billed from your prepaid Bytewells credits, and a run that returns nothing costs only its compute.

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