# CMS PECOS Medicare Provider Enrollment Scraper API (`pink_comic/cms-pecos-medicare-provider-enrollment-screening`) Actor Screen official CMS PECOS-derived Medicare enrollment evidence by NPI, provider, organization, state, or provider type. Merge active enrollment, PAC/enrollment IDs, order/referring authority, opt-out affidavits, revalidation, and revocation/re-enrollment-bar evidence. - **URL**: https://apify.com/pink\_comic/cms-pecos-medicare-provider-enrollment-screening.md - **Developed by:** [Ava Torres](https://apify.com/pink_comic) (community) - **Categories:** Business - **Stats:** 2 total users, 1 monthly users, 100.0% runs succeeded, 0 bookmarks - **User rating**: No ratings yet ## Pricing from $2.00 / 1,000 results 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/platform/actors/running/actors-in-store#pay-per-event ## What's an Apify Actor? Actors are a software tools running on the Apify platform, for all kinds of web data extraction and automation use cases. 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. Actors are written with capital "A". ## 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. The best way to integrate Actors is as follows. In JavaScript/TypeScript projects, use official [JavaScript/TypeScript client](https://docs.apify.com/api/client/js/docs.md): ```bash npm install apify-client ``` In Python projects, use official [Python client library](https://docs.apify.com/api/client/python/docs.md): ```bash pip install apify-client ``` In shell scripts, use [Apify CLI](https://docs.apify.com/cli/docs.md): ````bash # MacOS / Linux curl -fsSL https://apify.com/install-cli.sh | bash # Windows irm https://apify.com/install-cli.ps1 | iex ```bash In AI frameworks, you might use the [Apify MCP server](https://docs.apify.com/integrations/mcp.md). If your project is in a different language, use the [REST API](https://docs.apify.com/api/v2.md). For usage examples, see the [API](#api) section below. For more details, see Apify documentation as [Markdown index](https://docs.apify.com/llms.txt) and [Markdown full-text](https://docs.apify.com/llms-full.txt). # README ## CMS PECOS Medicare Provider Enrollment Scraper API Screen official CMS public Medicare provider-enrollment evidence populated from the Provider Enrollment, Chain, and Ownership System (PECOS). Search by exact NPI, provider or organization keyword, legal name, enrollment state, or CMS provider type. Exact-NPI screening merges five official CMS evidence surfaces: - active Medicare Fee-for-Service public provider enrollment - PECOS Associate Control/PAC IDs and enrollment IDs - ordering/referring authority for Part B, DME, home health, PMD, and hospice - provider opt-out affidavits and current effective periods - revalidation records, specialties, due dates, and reassignment counts - published revocations, reasons, effective dates, and re-enrollment-bar expiration dates Built for payer and provider credentialing, revenue-cycle and claims QA, healthcare compliance, network management, provider onboarding, sales research, Medicare enrollment verification, and public-record enrichment. ### Fast first run Click **Start** with the default input: ```json { "npi": "1003879883", "includeStatusChecks": true, "maxResults": 25 } ```` The deterministic example returns an active Medicare enrollment for Antonio Alvarez Rodriguez, its PAC/enrollment IDs, ordering/referring flags, and linked revalidation evidence. ### High-value searches #### Exact NPI screening ```json { "npi": "1003000126", "includeStatusChecks": true } ``` An exact NPI takes precedence over other filters and always checks all five datasets. Multiple active enrollment rows are aggregated into one provider result with nested `enrollments`. #### Organization search Clear the default `npi`, then use a keyword: ```json { "npi": "", "query": "MAYO CLINIC", "state": "MN", "includeStatusChecks": true, "maxResults": 25 } ``` `query` performs CMS full-text matching. `organizationName`, `firstName`, `lastName`, and `providerType` are exact filters. #### Opt-out evidence by NPI ```json { "npi": "1720444581" } ``` If an NPI is absent from the active-enrollment extract but appears in a supplemental source, the actor returns `CMS_PECOS_STATUS_ONLY_FOUND` rather than an ambiguous no-match. #### Revocation and re-enrollment-bar evidence ```json { "npi": "1801839063" } ``` Published revocation evidence includes every matched enrollment, CMS's stated authority/reason, effective date, re-enrollment-bar expiration date, and a retrieval-date `currentReenrollmentBar` calculation. ### Output Each NPI result can include: - active-enrollment indicator and count - provider and organization names - enrollment states and CMS provider types - PECOS Associate Control/PAC IDs and enrollment IDs - every underlying active enrollment row - ordering/referring flags by service category - opt-out affidavit periods, specialty, address, and current-period calculation - revalidation enrollment type, specialty, due dates, and reassignment counts - revocation reasons, dates, and current re-enrollment-bar evidence - query count, retrieval time, official CMS links, refresh cadence, and interpretation caveats No-match searches produce one explicit `NO_MATCHING_MEDICARE_ENROLLMENT_EVIDENCE` item. Temporary failure of the required active-enrollment source produces `SOURCE_UNAVAILABLE`. If a supplemental source fails while the primary source succeeds, the provider record remains usable and names the affected source in `supplementalSourceErrors`. ### Official sources and cadence The actor uses CMS's public, no-key Data API and the stable `latest` dataset identifiers for: 1. [Medicare Fee-For-Service Public Provider Enrollment](https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/medicare-fee-for-service-public-provider-enrollment) 2. [Order and Referring](https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/order-and-referring) 3. [Opt Out Affidavits](https://data.cms.gov/tools/provider-opt-out-affidavits-look-up-tool) 4. [Revalidation Due Date List](https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/revalidation-due-date-list) 5. [Revoked Medicare Providers and Suppliers](https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/revoked-medicare-providers-and-suppliers) The active-enrollment extract is a quarterly PECOS snapshot. Ordering/referring is refreshed frequently; opt-out and revalidation files are generally monthly; revocation data follows CMS publication updates. ### Important interpretation limits - CMS says the public PECOS-derived files are not real-time reporting; PECOS changes from day to day while public files update on their own schedules. - Appearing in the active public extract means the provider was actively approved to bill Medicare or had completed an 855O when CMS produced the snapshot. It is not a complete credential, license, sanction, quality, or claims-payment determination. - A missing active record does not by itself prove that a provider is ineligible, terminated, revoked, or unable to furnish any Medicare service. - Ordering/referring flags are service-category evidence from CMS's published list; use the relevant CMS rules and current records for claims decisions. - Opt-out, revalidation, and revocation records have distinct meanings. Do not collapse one into another. - Names can change and an NPI can have multiple enrollment rows. Exact NPI, PAC ID, and enrollment ID evidence is stronger than name-only matching. - Verify consequential credentialing, payment, network, or compliance decisions with CMS, the relevant Medicare Administrative Contractor, and current underlying records. ### Pricing This actor uses pay-per-event pricing. Check the live Apify Store pricing panel for current per-start and per-result rates. # Actor input Schema ## `npi` (type: `string`): Exact 10-digit National Provider Identifier. Exact NPI searches check all five CMS evidence datasets and take precedence over other filters. ## `query` (type: `string`): Full-text search across the active public enrollment extract, such as MAYO CLINIC or a practitioner surname. Clear the default NPI before using this field. ## `firstName` (type: `string`): Exact provider first name in the active enrollment extract. Clear the default NPI first. ## `lastName` (type: `string`): Exact provider last name in the active enrollment extract. Clear the default NPI first. ## `organizationName` (type: `string`): Exact organization name. Use query for partial/full-text matching. Clear the default NPI first. ## `state` (type: `string`): Exact two-letter state or territory abbreviation for active enrollment searches. ## `providerType` (type: `string`): Exact CMS provider type description, such as PRACTITIONER - INTERNAL MEDICINE. ## `includeStatusChecks` (type: `boolean`): For each matched NPI, also check ordering/referring, opt-out, revalidation, and revocation datasets. Exact NPI searches always perform these checks. ## `maxResults` (type: `integer`): Total aggregated provider/NPI results. One NPI can contain multiple enrollment records. ## Actor input object example ```json { "npi": "1003879883", "includeStatusChecks": true, "maxResults": 25 } ``` # 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 '' with your token const client = new ApifyClient({ token: '', }); // Prepare Actor input const input = { "npi": "1003879883", "includeStatusChecks": true, "maxResults": 25 }; // Run the Actor and wait for it to finish const run = await client.actor("pink_comic/cms-pecos-medicare-provider-enrollment-screening").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 '' with your token. client = ApifyClient("") # Prepare the Actor input run_input = { "npi": "1003879883", "includeStatusChecks": True, "maxResults": 25, } # Run the Actor and wait for it to finish run = client.actor("pink_comic/cms-pecos-medicare-provider-enrollment-screening").call(run_input=run_input) # Fetch and print Actor results from the run's dataset (if there are any) print("💾 Check your data here: https://console.apify.com/storage/datasets/" + run["defaultDatasetId"]) for item in client.dataset(run["defaultDatasetId"]).iterate_items(): print(item) # 📚 Want to learn more 📖? Go to → https://docs.apify.com/api/client/python/docs/quick-start ``` ## CLI example ```bash echo '{ "npi": "1003879883", "includeStatusChecks": true, "maxResults": 25 }' | apify call pink_comic/cms-pecos-medicare-provider-enrollment-screening --silent --output-dataset ``` ## MCP server setup ```json { "mcpServers": { "apify": { "command": "npx", "args": [ "mcp-remote", "https://mcp.apify.com/?tools=pink_comic/cms-pecos-medicare-provider-enrollment-screening", "--header", "Authorization: Bearer " ] } } } ``` ## OpenAPI specification ```json { "openapi": "3.0.1", "info": { "title": "CMS PECOS Medicare Provider Enrollment Scraper API", "description": "Screen official CMS PECOS-derived Medicare enrollment evidence by NPI, provider, organization, state, or provider type. Merge active enrollment, PAC/enrollment IDs, order/referring authority, opt-out affidavits, revalidation, and revocation/re-enrollment-bar evidence.", "version": "0.1", "x-build-id": "2CwAwtmZVsxAxkEn3" }, "servers": [ { "url": "https://api.apify.com/v2" } ], "paths": { "/acts/pink_comic~cms-pecos-medicare-provider-enrollment-screening/run-sync-get-dataset-items": { "post": { "operationId": "run-sync-get-dataset-items-pink_comic-cms-pecos-medicare-provider-enrollment-screening", "x-openai-isConsequential": false, "summary": "Executes an Actor, waits for its completion, and returns Actor's dataset items in response.", "tags": [ "Run Actor" ], "requestBody": { "required": true, "content": { "application/json": { "schema": { "$ref": "#/components/schemas/inputSchema" } } } }, "parameters": [ { "name": "token", "in": "query", "required": true, "schema": { "type": "string" }, "description": "Enter your Apify token here" } ], "responses": { "200": { "description": "OK" } } } }, "/acts/pink_comic~cms-pecos-medicare-provider-enrollment-screening/runs": { "post": { "operationId": "runs-sync-pink_comic-cms-pecos-medicare-provider-enrollment-screening", "x-openai-isConsequential": false, "summary": "Executes an Actor and returns information about the initiated run in response.", "tags": [ "Run Actor" ], "requestBody": { "required": true, "content": { "application/json": { "schema": { "$ref": "#/components/schemas/inputSchema" } } } }, "parameters": [ { "name": "token", "in": "query", "required": true, "schema": { "type": "string" }, "description": "Enter your Apify token here" } ], "responses": { "200": { "description": "OK", "content": { "application/json": { "schema": { "$ref": "#/components/schemas/runsResponseSchema" } } } } } } }, "/acts/pink_comic~cms-pecos-medicare-provider-enrollment-screening/run-sync": { "post": { "operationId": "run-sync-pink_comic-cms-pecos-medicare-provider-enrollment-screening", "x-openai-isConsequential": false, "summary": "Executes an Actor, waits for completion, and returns the OUTPUT from Key-value store in response.", "tags": [ "Run Actor" ], "requestBody": { "required": true, "content": { "application/json": { "schema": { "$ref": "#/components/schemas/inputSchema" } } } }, "parameters": [ { "name": "token", "in": "query", "required": true, "schema": { "type": "string" }, "description": "Enter your Apify token here" } ], "responses": { "200": { "description": "OK" } } } } }, "components": { "schemas": { "inputSchema": { "type": "object", "properties": { "npi": { "title": "Exact NPI", "pattern": "^$|^[0-9]{10}$", "type": "string", "description": "Exact 10-digit National Provider Identifier. Exact NPI searches check all five CMS evidence datasets and take precedence over other filters.", "default": "1003879883" }, "query": { "title": "Provider or Organization Keyword", "minLength": 2, "type": "string", "description": "Full-text search across the active public enrollment extract, such as MAYO CLINIC or a practitioner surname. Clear the default NPI before using this field." }, "firstName": { "title": "Exact First Name", "minLength": 2, "type": "string", "description": "Exact provider first name in the active enrollment extract. Clear the default NPI first." }, "lastName": { "title": "Exact Last Name", "minLength": 2, "type": "string", "description": "Exact provider last name in the active enrollment extract. Clear the default NPI first." }, "organizationName": { "title": "Exact Legal Organization Name", "minLength": 2, "type": "string", "description": "Exact organization name. Use query for partial/full-text matching. Clear the default NPI first." }, "state": { "title": "Enrollment State", "pattern": "^[A-Za-z]{2}$", "type": "string", "description": "Exact two-letter state or territory abbreviation for active enrollment searches." }, "providerType": { "title": "Exact CMS Provider Type", "minLength": 2, "type": "string", "description": "Exact CMS provider type description, such as PRACTITIONER - INTERNAL MEDICINE." }, "includeStatusChecks": { "title": "Merge Supplemental Status Evidence", "type": "boolean", "description": "For each matched NPI, also check ordering/referring, opt-out, revalidation, and revocation datasets. Exact NPI searches always perform these checks.", "default": true }, "maxResults": { "title": "Maximum Providers", "minimum": 1, "maximum": 100, "type": "integer", "description": "Total aggregated provider/NPI results. One NPI can contain multiple enrollment records.", "default": 25 } } }, "runsResponseSchema": { "type": "object", "properties": { "data": { "type": "object", "properties": { "id": { "type": "string" }, "actId": { "type": "string" }, "userId": { "type": "string" }, "startedAt": { "type": "string", "format": "date-time", "example": "2025-01-08T00:00:00.000Z" }, "finishedAt": { "type": "string", "format": "date-time", "example": "2025-01-08T00:00:00.000Z" }, "status": { "type": "string", "example": "READY" }, "meta": { "type": "object", "properties": { "origin": { "type": "string", "example": "API" }, "userAgent": { "type": "string" } } }, "stats": { "type": "object", "properties": { "inputBodyLen": { "type": "integer", "example": 2000 }, "rebootCount": { "type": "integer", "example": 0 }, "restartCount": { "type": "integer", "example": 0 }, "resurrectCount": { "type": "integer", "example": 0 }, "computeUnits": { "type": "integer", "example": 0 } } }, "options": { "type": "object", "properties": { "build": { "type": "string", "example": "latest" }, "timeoutSecs": { "type": "integer", "example": 300 }, "memoryMbytes": { "type": "integer", "example": 1024 }, "diskMbytes": { "type": "integer", "example": 2048 } } }, "buildId": { "type": "string" }, "defaultKeyValueStoreId": { "type": "string" }, "defaultDatasetId": { "type": "string" }, "defaultRequestQueueId": { "type": "string" }, "buildNumber": { "type": "string", "example": "1.0.0" }, "containerUrl": { "type": "string" }, "usage": { "type": "object", "properties": { "ACTOR_COMPUTE_UNITS": { "type": "integer", "example": 0 }, "DATASET_READS": { "type": "integer", "example": 0 }, "DATASET_WRITES": { "type": "integer", "example": 0 }, "KEY_VALUE_STORE_READS": { "type": "integer", "example": 0 }, "KEY_VALUE_STORE_WRITES": { "type": "integer", "example": 1 }, "KEY_VALUE_STORE_LISTS": { "type": "integer", "example": 0 }, "REQUEST_QUEUE_READS": { "type": "integer", "example": 0 }, "REQUEST_QUEUE_WRITES": { "type": "integer", "example": 0 }, "DATA_TRANSFER_INTERNAL_GBYTES": { "type": "integer", "example": 0 }, "DATA_TRANSFER_EXTERNAL_GBYTES": { "type": "integer", "example": 0 }, "PROXY_RESIDENTIAL_TRANSFER_GBYTES": { "type": "integer", "example": 0 }, "PROXY_SERPS": { "type": "integer", "example": 0 } } }, "usageTotalUsd": { "type": "number", "example": 0.00005 }, "usageUsd": { "type": "object", "properties": { "ACTOR_COMPUTE_UNITS": { "type": "integer", "example": 0 }, "DATASET_READS": { "type": "integer", "example": 0 }, "DATASET_WRITES": { "type": "integer", "example": 0 }, "KEY_VALUE_STORE_READS": { "type": "integer", "example": 0 }, "KEY_VALUE_STORE_WRITES": { "type": "number", "example": 0.00005 }, "KEY_VALUE_STORE_LISTS": { "type": "integer", "example": 0 }, "REQUEST_QUEUE_READS": { "type": "integer", "example": 0 }, "REQUEST_QUEUE_WRITES": { "type": "integer", "example": 0 }, "DATA_TRANSFER_INTERNAL_GBYTES": { "type": "integer", "example": 0 }, "DATA_TRANSFER_EXTERNAL_GBYTES": { "type": "integer", "example": 0 }, "PROXY_RESIDENTIAL_TRANSFER_GBYTES": { "type": "integer", "example": 0 }, "PROXY_SERPS": { "type": "integer", "example": 0 } } } } } } } } } } ```