# NPI Registry Lookup with OIG Exclusion Check (`hamsmoothie/npi-registry-lookup`) Actor

Search the official CMS NPI registry by name, organization, NPI, specialty, city or state and flag providers that appear on the HHS OIG LEIE exclusion list.

- **URL**: https://apify.com/hamsmoothie/npi-registry-lookup.md
- **Developed by:** [Maybe Quark](https://apify.com/hamsmoothie) (community)
- **Categories:** Other, Developer tools
- **Stats:** 2 total users, 1 monthly users, 100.0% runs succeeded, 0 bookmarks
- **User rating**: No ratings yet

## Pricing

$2.00 / 1,000 one npi provider record with exclusion flags

This Actor is paid per event. You are not charged for the Apify platform usage, but only a fixed price for specific events.

Learn more: https://docs.apify.com/actors/running/actors-in-store.md#pay-per-event

## What's an Apify Actor?

An Actor is a serverless cloud program that runs on the Apify platform. It has two run modes.
In Batch mode, an Actor accepts a well-defined JSON input, performs an action which can take anything from a few seconds to a few hours,
and optionally produces a well-defined JSON output, datasets with results, or files in key-value store.
In Standby mode, an Actor provides a web server which can be used as a website, API, or an MCP server.

Apify vocabulary and the platform model are defined once, in the agent quickstart at https://apify.com/agents.md.

## How to integrate an Actor?

If asked about integration, you help developers integrate Actors into their projects.
You adapt to their stack and deliver integrations that are safe, well-documented, and production-ready.

Do not guess an integration path. Every one of them is in the agent quickstart at https://apify.com/agents.md: the Apify MCP server, Agent Skills with the Apify CLI, the JavaScript and Python clients, the REST API, and the account-free path for an agent with no human to sign in. It also carries the rule on stating cost before the first paid run.

For examples already wired to this Actor's own input schema, see the [API](#api) section below.

Each client library has reference documentation the quickstart does not restate: [JavaScript/TypeScript](https://docs.apify.com/api/client/js/docs.md) (`npm install apify-client`) and [Python](https://docs.apify.com/api/client/python/docs.md) (`pip install apify-client`).

# README

## NPI Registry Lookup with OIG Exclusion Check (NPPES + LEIE)

**NPI Registry Lookup** searches the official CMS NPPES NPI registry by NPI number, provider name, organization, specialty, city or state and returns one clean row per provider: NPI, type, name, credential, status, primary taxonomy, license, practice address, phone and registry dates. With `checkExclusions` on (the default), each row is also checked against the HHS OIG LEIE exclusion list and flagged `excluded` true or false. It uses public data only: the CMS NPI registry API and the OIG LEIE download.

### Input

Set any of `npi`, `firstName`, `lastName`, `organizationName`, `taxonomyDescription`, `city`, `state`. This example finds cardiology practices in Houston and checks them against the exclusion list:

```json
{
  "taxonomyDescription": "Cardiology",
  "city": "Houston",
  "state": "TX",
  "enumerationType": "",
  "maxResults": 50,
  "checkExclusions": true
}
```

- `npi`: exact 10-digit NPI. If set, other search fields are ignored.
- `firstName`, `lastName`: individual providers; a trailing `*` wildcard is allowed after 2 characters.
- `organizationName`: clinics, hospitals and groups.
- `taxonomyDescription`: for example `Dentist`, `Cardiology`, `Nurse Practitioner`.
- `city`, `state`: practice location; state is a two-letter code.
- `enumerationType`: `NPI-1` individuals, `NPI-2` organizations, or blank for both.
- `maxResults`: rows to return (default 50; the registry caps one search at 1,200).
- `checkExclusions`: download the OIG LEIE file and flag matches by NPI or by name and state.

### Output

One row per provider. Real example row for an organization:

```json
{
  "npi": "1881018208",
  "enumeration_type": "NPI-2",
  "name": "MAYO CLINIC",
  "credential": null,
  "status": "A",
  "primary_taxonomy": "Clinic/Center, Multi-Specialty",
  "license_number": null,
  "license_state": null,
  "practice_address": "200 1ST ST SW",
  "practice_city": "ROCHESTER",
  "practice_state": "MN",
  "practice_zip": "559050001",
  "phone": "507-284-2511",
  "enumeration_date": "2014-02-05",
  "last_updated": "2021-04-12",
  "excluded": false,
  "exclusion_match_type": null,
  "exclusion_type": null,
  "exclusion_date": null,
  "reinstatement_date": null,
  "url": "https://npiregistry.cms.hhs.gov/provider-view/1881018208"
}
```

When a provider matches the exclusion list, `excluded` is true and `exclusion_match_type` is `NPI` or `NAME_AND_STATE`, with `exclusion_type`, `exclusion_date` and `reinstatement_date` filled in.

### Use cases

Search phrases this actor is built for:

- **"NPI number lookup"**: pass `npi`, or search by name and state to find a provider's NPI.
- **"Search NPI registry by specialty and city"**: set `taxonomyDescription`, `city` and `state` to build a provider list.
- **"NPI provider OIG exclusion check"**: leave `checkExclusions` on to screen a clinician or organization before hiring or billing.

Typical users are credentialing teams, healthcare staffing and billing companies and compliance officers. For bulk screening of names or NPIs against OIG plus OFAC, see the exclusion-debarment-screener actor by the same publisher.

### Pricing

Pay per result: each provider row returned is one billable result, listed at $0.002 per row ($2 per 1,000). Set a maximum charge on the run for a hard ceiling.

### Limits

- The NPI registry caps one search at 1,200 results; narrow the search to go further.
- A `NAME_AND_STATE` exclusion match is a lead to verify on the OIG site, not a definitive finding; an `NPI` match is stronger. This is not legal or compliance advice.
- The registry is queried live. The LEIE file is downloaded on every run when `checkExclusions` is on.

### FAQ

**Where does the data come from?** The CMS NPPES API (npiregistry.cms.hhs.gov) and the HHS OIG LEIE downloadable file (oig.hhs.gov).

**Is a name-based exclusion match definitive?** No. Verify it on the OIG site.

**Can I search organizations?** Yes. Use `organizationName` or set `enumerationType` to `NPI-2`.

# Actor input Schema

## `npi` (type: `string`):

Exact 10-digit NPI. If set, other search fields are ignored.

## `firstName` (type: `string`):

Provider first name (individuals). Trailing \* wildcard allowed after 2 characters.

## `lastName` (type: `string`):

Provider last name (individuals).

## `organizationName` (type: `string`):

Organization legal name (clinics, hospitals, groups).

## `taxonomyDescription` (type: `string`):

For example Dentist, Cardiology, Nurse Practitioner.

## `city` (type: `string`):

Practice city.

## `state` (type: `string`):

Two-letter state code.

## `enumerationType` (type: `string`):

NPI-1 individuals, NPI-2 organizations, or blank for both.

## `maxResults` (type: `integer`):

Maximum rows to return (the registry caps one search at 1200).

## `checkExclusions` (type: `boolean`):

Download the OIG LEIE file and flag matches by NPI or by name and state.

## Actor input object example

```json
{
  "npi": "",
  "firstName": "John",
  "lastName": "Smith",
  "organizationName": "",
  "taxonomyDescription": "",
  "city": "",
  "state": "CA",
  "enumerationType": "",
  "maxResults": 50,
  "checkExclusions": true
}
```

# Actor output Schema

## `results` (type: `string`):

No description

# API

You can run this Actor programmatically using our API. Below are code examples in JavaScript, Python, and CLI, as well as the OpenAPI specification and MCP server setup.

## JavaScript example

```javascript
import { ApifyClient } from 'apify-client';

// Initialize the ApifyClient with your Apify API token
// Replace the '<YOUR_API_TOKEN>' with your token
const client = new ApifyClient({
    token: '<YOUR_API_TOKEN>',
});

// Prepare Actor input
const input = {};

// Run the Actor and wait for it to finish
const run = await client.actor("hamsmoothie/npi-registry-lookup").call(input);

// Fetch and print Actor results from the run's dataset (if any)
console.log('Results from dataset');
console.log(`💾 Check your data here: https://console.apify.com/storage/datasets/${run.defaultDatasetId}`);
const { items } = await client.dataset(run.defaultDatasetId).listItems();
items.forEach((item) => {
    console.dir(item);
});

// 📚 Want to learn more 📖? Go to → https://docs.apify.com/api/client/js/docs

```

## Python example

```python
from apify_client import ApifyClient

# Initialize the ApifyClient with your Apify API token
# Replace '<YOUR_API_TOKEN>' with your token.
client = ApifyClient("<YOUR_API_TOKEN>")

# Prepare the Actor input
run_input = {}

# Run the Actor and wait for it to finish
run = client.actor("hamsmoothie/npi-registry-lookup").call(run_input=run_input)

# Fetch and print Actor results from the run's dataset (if there are any)
print(f"💾 Check your data here: https://console.apify.com/storage/datasets/{run.default_dataset_id}")
for item in client.dataset(run.default_dataset_id).iterate_items():
    print(item)

# 📚 Want to learn more 📖? Go to → https://docs.apify.com/api/client/python/docs/quick-start

```

## CLI example

```bash
echo '{}' |
apify call hamsmoothie/npi-registry-lookup --silent --output-dataset

```

## MCP server setup

```json
{
    "mcpServers": {
        "apify": {
            "type": "http",
            "url": "https://mcp.apify.com/?tools=fetch-actor-details,hamsmoothie/npi-registry-lookup"
        }
    }
}
```

The hosted server signs you in with OAuth on first connect, so no API token belongs in this config. Clients without OAuth support can send an `Authorization: Bearer <APIFY_API_TOKEN>` header instead, using a token from API & Integrations in Apify Console (https://console.apify.com/settings/integrations).

## OpenAPI specification

Download the OpenAPI definition: https://api.apify.com/v2/actors/FeJqAGqnF9VkWH8Nd/builds/mvsEcxHPY8o74foi4/openapi.json