# US CMS Medicare PPEF NPI Portfolio Enrollment Status Monitor (`plym-actor-factory/us-cms-ppef-npi-portfolio-enrollment-monitor`) Actor

Watch NPIs and emit typed ENROLLED/DROPPED/PROVIDER\_TYPE\_CHANGED/ENROLLMENT\_ID\_CHANGED events from the official CMS data.cms.gov Medicare Fee-For-Service Public Provider Enrollment (PPEF) extract. Not PECOS portal HTML scrape; not NPPES directory dump; not PEPM SaaS.

- **URL**: https://apify.com/plym-actor-factory/us-cms-ppef-npi-portfolio-enrollment-monitor.md
- **Developed by:** [Daniel Witney](https://apify.com/plym-actor-factory) (community)
- **Categories:** AI, Automation, Business
- **Stats:** 2 total users, 1 monthly users, 100.0% runs succeeded, 0 bookmarks
- **User rating**: No ratings yet

## Pricing

from $20.00 / 1,000 ppef npi enrollment event delivereds

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

## US CMS Medicare PPEF NPI Portfolio Enrollment Status Monitor

Watch a book of **NPIs** and emit typed enrollment events when the official **CMS data.cms.gov Medicare Fee-For-Service Public Provider Enrollment (PPEF)** extract shows a provider **appearing**, **disappearing**, or changing **provider type / enrollment ID** linkage.

**Not** a PECOS portal HTML screener. **Not** an NPPES directory dump. **Not** unpaid PEPM / credentialing SaaS scrape.

### Coverage honesty (PPEF FFS vs full PECOS)

PPEF is a **public Fee-For-Service enrollment extract** derived from PECOS and published on data.cms.gov. **Absence from this extract is not proof of every possible Medicare enrollment status** (e.g. private PECOS portal states, non-FFS programs). Cadence follows the CMS publish schedule (periodic extract, not streaming). Product fields default to NPI + enrollment IDs + provider type + state (minimize unnecessary name fields when the customer supplies an NPI-only book).

### Events

| Event | When |
|-------|------|
| `PPEF_NPI_ENROLLED` | Watched NPI missing → present on extract |
| `PPEF_NPI_DROPPED` | Watched NPI present → missing on extract |
| `PPEF_ENROLLMENT_ID_CHANGED` | `ENRLMT_ID` set changed while still present |
| `PPEF_PROVIDER_TYPE_CHANGED` | `PROVIDER_TYPE_CD` / `PROVIDER_TYPE_DESC` fingerprint changed |
| `RUN_STATUS` | Non-billable health row every successful run |

First observation of an NPI stores a **baseline only** (no product charge).

### Modes

- **`sourceMode=fixture`** (default): Store health / CI. With `emitFixtureDemoEvents=false` (default) emits **only** `RUN_STATUS` / `FIXTURE_HEALTH` → **0** product charges.
- **`sourceMode=live`**: Official CMS data-api `filter[NPI]=…` against the PPEF Enrollment dataset (**no API key**). Portfolio-safe — does **not** download the national ~320MB CSV by default.

### Pricing (Model A)

- `ppef-npi-enrollment-event-delivered` @ **$0.02** / unique delivered event
- `apify-actor-start` @ **$0.00005**
- Quiet books ≈ $0 product charge

### Input

See `.actor/input_schema.json`. Primary field: `npis` (10-digit). Optional `signalGroups`: `enrollment`, `provider_type`.

### Legal

**GREEN** — CMS data.cms.gov public dataset. Cite CMS + extract date. No medical records in default product fields.

### A1b wedge

NPI watchlist × scheduled PPEF snapshot diff → typed enrollment events only for the book. Existing Store shelf is PECOS screeners / NPPES dumps (wrong job). See `opportunity/reports/phase3-a1b-next3-v10.md`.

# Actor input Schema

## `npis` (type: `array`):

National Provider Identifiers (10-digit) to monitor against the official CMS PPEF FFS Public Provider Enrollment extract. Invalid entries are skipped with no charge. Not a nationwide dump — only NPIs on the book are evaluated.

## `signalGroups` (type: `array`):

Which change groups to evaluate: enrollment (ENROLLED/DROPPED/ENROLLMENT\_ID\_CHANGED), provider\_type (PROVIDER\_TYPE\_CHANGED). Default: both.

## `maxRunSeconds` (type: `integer`):

Wall-clock budget for the run (API queries + watchlist diff).

## `maxEvents` (type: `integer`):

Stop after this many unique change events are delivered (does not include RUN\_STATUS).

## `resumeFromCheckpoint` (type: `boolean`):

If true, resume NPI snapshots and seen event\_uids from the default Key-Value Store.

## `sourceMode` (type: `string`):

fixture = local/CI / Apify Store daily auto-test default (no network; emits RUN\_STATUS only unless emitFixtureDemoEvents=true). live = official CMS data.cms.gov PPEF data-api (no API key). Not PECOS HTML scrape; not NPPES dump; not PEPM SaaS.

## `emitFixtureDemoEvents` (type: `boolean`):

When sourceMode=fixture, if true push fabricated change events from local fixtures (unit/local demos only). Default false so Store daily auto-tests never emit fake PPEF events or charge ppef-npi-enrollment-event-delivered. Production: leave false and use sourceMode=live. SAMPLE rows only: demo events use placeholder entities (never real companies/IDs), are flagged sample=true / isSample=true, and are NEVER charged.

## `asOfHint` (type: `string`):

Optional as\_of label for events / RUN\_STATUS. Defaults to the extract date (2026-07-17 for current published extract).

## `maxTotalChargeUsd` (type: `number`):

Optional soft budget hint for delivered change events. Platform ACTOR\_MAX\_TOTAL\_CHARGE\_USD also applies when set.

## `datasetApiUrl` (type: `string`):

Optional override for the official PPEF Enrollment dataset data-api URL. Default: https://data.cms.gov/data-api/v1/dataset/2457ea29-fc82-48b0-86ec-3b0755de7515/data

## Actor input object example

```json
{
  "npis": [
    "1003879883",
    "1992766174",
    "1093779522"
  ],
  "signalGroups": [
    "enrollment",
    "provider_type"
  ],
  "maxRunSeconds": 55,
  "maxEvents": 500,
  "resumeFromCheckpoint": true,
  "sourceMode": "fixture",
  "emitFixtureDemoEvents": false
}
```

# Actor output Schema

## `OUTPUT` (type: `string`):

JSON summary: delivered, charged, runStatus, checkpoint, stats, PPEF FFS coverage limits

# 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("plym-actor-factory/us-cms-ppef-npi-portfolio-enrollment-monitor").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("plym-actor-factory/us-cms-ppef-npi-portfolio-enrollment-monitor").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 plym-actor-factory/us-cms-ppef-npi-portfolio-enrollment-monitor --silent --output-dataset

```

## MCP server setup

```json
{
    "mcpServers": {
        "apify": {
            "type": "http",
            "url": "https://mcp.apify.com/?tools=fetch-actor-details,plym-actor-factory/us-cms-ppef-npi-portfolio-enrollment-monitor"
        }
    }
}
```

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/8lvcbF7Zd2iuqhkXZ/builds/UyqgNnYIhZdjfq8MF/openapi.json