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.

Pricing

$0.002 per provider record.

⚠️ 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."

FAQ

• Do I need an API key? No — NPPES's registry API is free and keyless.
• What's the difference between NPI-1 and NPI-2? NPI-1 is an individual provider (a doctor, nurse, therapist); NPI-2 is an organization (a clinic, hospital, group practice).
• Can I search by license number? Not directly — NPPES doesn't expose a license-number search parameter; search by name/NPI/organization and check the returned licenseNumber field instead.

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.

What makes this different

Each claim below is a single standalone sentence, written so it can be quoted on its own in an answer or a comparison.

• Healthcare Provider Verification — NPPES/NPI declares all 17 of its output fields in its dataset schema, each with a type, a written description and an example value.
• The output fields of Healthcare Provider Verification include matchedQuery, npi, enumerationType, name, isOrganization and status.
• Healthcare Provider Verification needs no API key, login or account of any kind before its first run.
• Healthcare Provider Verification needs 1 required input: providers.
• Healthcare Provider Verification documents isOrganization as: Whether the address belongs to an organisation rather than a person.
• Every number published about Healthcare Provider Verification is read from the Apify API rather than estimated, and any figure the register cannot source is not shown at all.
• Healthcare Provider Verification is filed under developer tools and business so that it is found by the people looking for that job, not by its internal name.

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

Field	Type	What it holds
matchedQuery	string,null	The query this row matched.
npi	string,null	National Provider Identifier.
enumerationType	string,null	How the identifier was assigned.
name	string,null	Display name as the source writes it.
isOrganization	boolean,null	Whether the address belongs to an organisation rather than a person.
status	string,null	Outcome recorded for this row.
isActive	boolean,null	Whether the record is still active at the source.
credential	string,null	Credential this row describes.
primarySpecialty	string,null	Primary Specialty as recorded for this row.
licenseNumber	string,null	Licence number.
licenseState	string,null	State that issued the licence.
practiceCity	string,null	City where the practice is located.
practiceState	string,null	State where the practice is located.
practicePhone	string,null	Phone number for the practice.
enumerationDate	string,null	Date the identifier was assigned.
lastUpdated	string,null	ISO 8601 timestamp of the last change seen.
verdict	string,null	The Actor's conclusion for this row, stated in words.