CMS Medicare Provider Payments & Utilization Scraper

Export more than 1.29 million current CMS Medicare provider profiles with NPI, specialty, address, beneficiary volume, services, submitted charges, allowed amounts, Medicare payments and patient-population indicators. The Actor converts the official CMS provider-summary release into clean records for healthcare sales, market sizing, provider intelligence and payer analysis.

No CMS API key is required. The Actor uses the dataset's stable CMS identifier, which resolves to the current official release rather than depending on a fragile download-page URL.

What can you do with this Actor?

• Build national or state-level lists of physicians, groups and healthcare organizations.
• Rank providers by Medicare beneficiaries, service volume or reimbursement.
• Segment territories by specialty, geography and Medicare participation.
• Support pharma, medical-device, payer, healthcare staffing and market-research workflows.
• Enrich NPI-based databases with aggregate utilization and payment signals.
• Export optional beneficiary condition profiles for population-health analysis.

Input

All filters are optional. Empty input exports provider records from the current release.

Field	Type	Description
states	string[]	Exact two-letter provider state abbreviations.
specialties	string[]	Exact CMS specialty names such as Cardiology.
countries	string[]	Provider country codes; US records generally use US.
nameKeyword	string	Provider organization, last-name or first-name search.
medicareParticipatingOnly	boolean	Keep only providers with participating indicator Y.
minBeneficiaries	integer	Minimum distinct Medicare beneficiaries.
minServices	number	Minimum total Medicare services.
minMedicarePayment	number	Minimum aggregate Medicare payment in USD.
includeConditionProfile	boolean	Include aggregate condition percentages when present.
maxResults	integer	Maximum unique NPIs to save, up to 500,000.

Example for high-volume California cardiology providers:

{
  "states": ["CA"],
  "specialties": ["Cardiology"],
  "medicareParticipatingOnly": true,
  "minMedicarePayment": 50000,
  "includeConditionProfile": true,
  "maxResults": 10000
}

Output

Each dataset item is one provider-level profile keyed by NPI.

Field group	Included data
Identity	npi, provider name components, organization name, credentials, entity type, gender.
Classification	specialty, Medicare participation indicator.
Location	Address lines, city, state, ZIP, country and rural/urban code.
Volume	Total beneficiaries, services, unique HCPCS codes and beneficiary-day services.
Financial	Submitted charges, Medicare allowed amount, Medicare payment and standardized payment.
Population	Average age, risk score, female/male percentages, race indicators and dual/Medicare-only shares.
Conditions	Optional aggregate percentages for major chronic conditions available in the CMS release.
Lineage	Data year, official source URL and scrape timestamp.

{
  "npi": "1234567890",
  "providerName": "EXAMPLE CARDIOLOGY GROUP",
  "entityType": "O",
  "specialty": "Cardiology",
  "city": "LOS ANGELES",
  "state": "CA",
  "medicareParticipating": true,
  "totalBeneficiaries": 742,
  "totalServices": 5180,
  "totalSubmittedCharges": 2145000.75,
  "totalMedicarePayment": 387420.18,
  "dataYear": 2024
}

CMS suppresses some values to protect beneficiary privacy. Those values remain null; the Actor does not estimate or reconstruct them. Payment and utilization metrics are aggregate historical measures, not a statement about current provider availability or quality.

High-volume workflow tips

Use exact state and specialty filters to build focused territories quickly. For national market sizing, increase maxResults and let the Actor paginate the CMS API automatically. Multiple states and specialties are handled as independent source segments and NPIs are deduplicated across them. Join output to other NPI datasets using the normalized npi string.

minBeneficiaries, minServices and minMedicarePayment are applied to the normalized numeric values. Use them to prioritize commercially meaningful accounts without downloading irrelevant rows into your final dataset.

Integrations and API

Results are available through Apify datasets as JSON, JSONL, CSV, Excel, XML or RSS. Runs can be scheduled and connected to webhooks, Google Sheets, Make, Zapier, databases or your own ETL. JavaScript and Python Apify clients are supported.

curl -X POST "https://api.apify.com/v2/acts/logiover~cms-medicare-provider-payments-scraper/runs?token=YOUR_TOKEN" \
  -H "Content-Type: application/json" \
  -d '{"states":["TX"],"specialties":["Internal Medicine"],"maxResults":5000}'

Through Apify MCP, AI agents can also call the Actor as a structured provider-research tool.

FAQ

Which CMS dataset is used? The official Medicare Physician & Other Practitioners provider-level summary dataset.

How many records are available? The current release contains roughly 1.29 million provider records; availability varies as CMS updates releases.

Does it include individual claims? No. It provides privacy-protected provider-level aggregates.

Does it need an API key? No external CMS key is required.

Are all values populated? No. CMS suppression and source completeness can produce nulls.

Can I filter by multiple specialties? Yes. Use exact CMS specialty labels.

Is NPI preserved safely? Yes. It is returned as a string to avoid numeric formatting loss.

Can the Actor prove provider quality? No. Utilization and payment aggregates should not be interpreted as quality ratings.

Can I schedule annual refreshes? Yes. The stable source identifier follows the current CMS release; schedule runs to refresh your downstream index.

Responsible use

This Actor is not affiliated with or endorsed by CMS. Use the records for lawful research and business intelligence. Verify material healthcare decisions against authoritative sources and do not infer sensitive individual-patient information from aggregate data.

Changelog

2026-08-04

• Initial provider-level CMS Medicare payments and utilization release.
• Added state, specialty, country, name, participation, volume and payment filters.
• Added stable NPI deduplication and optional beneficiary condition fields.
• Validated numeric payment, volume, identity and location output against the live CMS API.