Medicare Opt-Out Providers List (CMS Affidavits) Scraper

Pulls the CMS Opt Out Affidavits dataset, every physician and practitioner who has opted out of Medicare, into clean JSON records: NPI, name, specialty, practice address, and the exact opt-out effective and end dates. Filter by state, specialty, ZIP prefix, effective date, name or NPI, or keep only providers whose opt-out is still in force.

About 57,500 records in the current release, refreshed monthly by CMS. A provider who opts out files an affidavit, stops billing Medicare entirely, and contracts privately with patients who pay out of pocket. This Actor turns that publication into records you can drop into a CRM, a territory model, or a spreadsheet.

Who uses this data

• Concierge medicine, direct primary care (DPC) and physician recruiters. A physician who has already opted out of Medicare has made the hard decision you are usually selling. Filter by state and specialty and you have a pre-qualified list.
• Private-pay and cash-pay networks building provider directories, especially in behavioural health: Clinical Psychologist, Mental Health Counselor, Clinical Social Worker and Marriage And Family Therapist are the four largest specialties in the file.
• Payer network teams who need to know which providers in a market are unavailable to a Medicare Advantage or fee-for-service network, and when each opt-out period ends.
• Compliance, credentialing and claims teams checking opt-out status against a date, and whether the provider is still eligible to order and refer.
• Health-economics researchers studying opt-out patterns by specialty, geography and time.

What you get

One dataset item per affidavit record.

{
  "source": "https://data.cms.gov/data-api/v1/dataset/9887a515-7552-4693-bf58-735c77af46d7/data",
  "attribution": "Centers for Medicare & Medicaid Services (CMS)",
  "recordKey": "abeab2dbc1ed6e26",
  "npi": "1720444581",
  "firstName": "Jonathan",
  "lastName": "Raines",
  "fullName": "Jonathan Raines",
  "specialty": "Psychiatry",
  "optoutEffectiveDate": "1998-01-30",
  "optoutEndDate": "2028-01-30",
  "currentlyOptedOut": true,
  "addressLine1": "1629 MONK RD",
  "addressLine2": "P O BOX 470",
  "city": "GLADWYNE",
  "state": "PA",
  "zipCode": "19035-1349",
  "zip5": "19035",
  "eligibleToOrderAndRefer": false,
  "lastUpdated": "2026-02-16",
  "fetchedAt": "2026-08-23T11:41:07.512Z"
}

Dates are ISO 8601 calendar dates; CMS publishes no time of day, so none is invented. Missing values are null, never an empty string. eligibleToOrderAndRefer is a real boolean, not "Y". Nine-digit ZIPs are hyphenated and zip5 is split out for joining. currentlyOptedOut is computed from optoutEndDate against the UTC date the run starts.

recordKey is a stable 16-character hash of every source column except CMS's Last updated stamp, so the same record produces the same key on every run and across monthly refreshes. Use it as an upsert key.

Records are delivered in the CMS API's own order and stop at maxResults. They are not re-sorted: a global sort would mean downloading all 57,500 rows on every run, which at the crawl delay this Actor honours takes about two minutes even for a hundred records. Every item carries its dates, so any ordering you want is one sort away.

A run summary is written to the key-value store under OUTPUT: source URL, the dataset size CMS reports, rows scanned, HTTP requests made, duplicates folded, records delivered and records charged, and whether the charge limit stopped the run.

Input

Everything is optional. Run it with no input and you get the first 100 records of the current release.

Field	Type	Default	Notes
state	string[]	-	US state, district or territory codes, e.g. ["NY", "NJ"]. Applied by the CMS API itself, so this is the fast filter. Several states share the record budget evenly.
specialty	string	-	Case-insensitive substring, so psych matches Psychiatry and Clinical Psychologist.
keyword	string	-	Case-insensitive substring across the provider's full name and NPI.
zipPrefix	string	-	1-9 digits matched against the start of the ZIP, e.g. 100 or 90210.
effectiveFrom	ISO date	-	Keep opt-outs effective on or after this date. This is how you find recent opt-outs.
effectiveTo	ISO date	-	Keep opt-outs effective on or before this date.
currentlyOptedOutOnly	boolean	false	Keep only records whose end date has not passed, as of the day the run starts.
maxResults	integer	100	1 to 20000. This is your cost cap: you pay per delivered record.
includeRaw	boolean	false	Attach a raw object with the CMS columns under their published names.

Filters combine with AND. Only state can be pushed to the CMS API; the rest are applied here, which means a run that uses them reads more of the dataset and takes longer. A state filter in front of them cuts that work down sharply.

Example inputs

Opted-out physicians in one state and specialty, still opted out (DPC and concierge recruiting):

{
  "state": ["TX"],
  "specialty": "Family",
  "currentlyOptedOutOnly": true,
  "maxResults": 1000
}

Recent opt-outs in your states (new-decision prospecting):

{
  "state": ["FL", "GA"],
  "effectiveFrom": "2026-01-01",
  "maxResults": 500
}

Check one provider's opt-out status (credentialing, claims):

{
  "keyword": "1720444581",
  "maxResults": 10
}

Pricing

$0.008 per record; you pay only for records delivered. One charge per dataset item, nothing else. Set maxResults and you have set your bill: 100 records is $0.80, 5,000 is $40.00. Filters are applied before delivery, so a narrow search costs less than a broad one, and a filter that matches nothing costs nothing.

Data source, refresh and licence

Records come from the Centers for Medicare & Medicaid Services (CMS), dataset Opt Out Affidavits, read through the public data.cms.gov data-api:

• Landing page: https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/opt-out-affidavits
• API endpoint: https://data.cms.gov/data-api/v1/dataset/9887a515-7552-4693-bf58-735c77af46d7/data
• Data dictionary: https://data.cms.gov/resources/opt-out-affidavits-data-dictionary (PDF)
• Methodology: https://data.cms.gov/sites/default/files/2020-07/OptOut_Methods.pdf

Refresh: CMS lists this dataset as monthly (accrualPeriodicity: R/P1M) and publishes it as a dated release; the July 2026 release was posted on 2026-08-20. Run this Actor monthly and you track CMS's own cadence. Each item also carries CMS's own lastUpdated stamp for that record.

Licence: CMS publishes this dataset in its open-data catalogue (https://data.cms.gov/data.json) with accessLevel: public, accessRights: Open, and the licence https://www.usa.gov/government-works.

Attribution: Centers for Medicare & Medicaid Services (CMS). This Actor is not affiliated with or endorsed by the Centers for Medicare & Medicaid Services or any US government agency. No login, API key or account is involved.

The data.cms.gov robots.txt allows /data-api/v1/dataset/* (only /data-api/v1/download-request and the view tracker are disallowed) and publishes crawl-delay: 10; this Actor waits ten seconds between requests, keeps one request in flight, sends a descriptive User-Agent, and caches nothing between runs.

Limitations

• This is the opt-out file, not a full provider directory. It covers only providers who filed an opt-out affidavit. There is no phone number, email, licence number or practice name in the source, and none is invented here.
• Recently expired affidavits stay in the file. 1,096 of 57,530 records had an end date in the past on 2026-08-23. Set currentlyOptedOutOnly if you only want live opt-outs.
• One provider can appear several times. An NPI with practice addresses in three states is three records, and a provider listed under two specialties at one address is two records. That is the source's structure, not a duplication bug. Deduplicate on npi yourself if you want one row per person. True duplicates, meaning byte-identical repeats, are folded away: 125 of 57,530 rows on 2026-08-23.
• Addresses are as CMS publishes them, upper case and unstandardised. They are not geocoded or validated.
• A local filter reads more of the dataset. A nationwide specialty, keyword, zipPrefix or date filter scans until it has enough records, up to about two minutes for the whole file. A state filter runs on the CMS API and is fast.
• Ordering is CMS's own. See the note above.
• The run fails rather than delivering a wrong answer. If CMS drops a column on any row of any page, serves a stub, or stops paginating before the row count its own stats endpoint reports, the run stops with an error and pushes nothing, so a broken source costs you nothing instead of quietly returning fewer records. That check covers state filters too: a state pass is compared against CMS's own count for that state, not just against the national total.

FAQ

How do I find doctors who have opted out of Medicare in my state?

Set state to the two-letter code (the one filter the CMS API applies itself, so it is fast) and optionally specialty. Add currentlyOptedOutOnly: true to drop providers whose opt-out period has ended.

How do I check whether a specific provider has opted out of Medicare?

Put the NPI or name in keyword. Each matching record carries optoutEffectiveDate, optoutEndDate and the computed currentlyOptedOut flag.

What does "opted out of Medicare" mean?

The provider filed an affidavit with CMS, does not bill Medicare for any service, and enters private contracts with Medicare patients who pay out of pocket. The opt-out runs for a fixed period from the effective date; optoutEndDate is when the current period ends.

Which specialties opt out of Medicare most?

In this file the four largest specialties are Clinical Psychologist, Mental Health Counselor, Clinical Social Worker and Marriage And Family Therapist. Use specialty as a substring filter (psych matches Psychiatry and Clinical Psychologist).

How often is the Medicare opt-out list updated?

Monthly. CMS publishes dated releases; the July 2026 release was posted on 2026-08-20, and every record carries CMS's own lastUpdated stamp.

Does the list include phone numbers or emails?

No. The source carries the practice address only. Join on npi against the NPPES registry for contact details.

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