Healthcare Credentialing Intelligence MCP Server

Provider verification and compliance intelligence via the Model Context Protocol. This MCP server orchestrates 8 data sources for provider compliance screening, sanctions/exclusion checks, publication activity scoring, malpractice pattern analysis, license verification, credential gap identification, provider comparison, and comprehensive credentialing reporting. Produces a Composite Credentialing Score (0-100) with verification verdicts. Built for hospitals, health insurers, staffing agencies, and compliance officers.

What data can you access?

Data Point	Source
US Treasury SDN list screening	OFAC Sanctions Search
Multi-jurisdiction watchlist and PEP screening	OpenSanctions Search
Patient and billing complaint patterns	CFPB Consumer Complaints
Practice corporate entity verification	OpenCorporates
NPI registry, OIG/LEIE exclusion databases	Data.gov
License enforcement and disciplinary proceedings	Federal Register
Academic identity and researcher profiles	ORCID Researcher Search
Peer-reviewed publication activity	PubMed Research Search

MCP Tools

Tool	Price	Description
provider_compliance_screen	$2.00	Screen healthcare provider for sanctions, exclusion lists, and regulatory compliance using OFAC, OpenSanctions, Federal Register enforcement actions, and Data.gov healthcare exclusion databases
sanctions_exclusion_check	$2.00	Deep sanctions and exclusion screening against OFAC SDN, OpenSanctions multi-list, OIG/LEIE exclusion databases, and CFPB complaint patterns
publication_activity_score	$2.00	Assess provider publication activity and research credentials via PubMed peer-reviewed papers and ORCID identity verification
malpractice_pattern_analysis	$2.00	Analyze malpractice complaint patterns using CFPB complaints, Federal Register enforcement/disciplinary actions, and Data.gov NPDB indicators
license_verification	$2.00	Verify provider licenses and certifications through OpenCorporates entity status, Federal Register licensing actions, Data.gov NPI/DEA records, and ORCID verification
credential_gap_check	$2.00	Identify gaps in provider credentialing by cross-referencing license verification, publication activity, and compliance records. Returns ENHANCED_VERIFICATION_REQUIRED, ADDITIONAL_DOCUMENTATION_NEEDED, or CREDENTIALS_SUFFICIENT
compare_providers	$2.00	Compare 2-5 healthcare providers side-by-side on compliance, sanctions, publications, malpractice, and license verification with ranked scoring
facility_credentialing_report	$12.00	Comprehensive credentialing intelligence report combining all 8 data sources with composite score, verdict, and detailed dimensional analysis

Data Sources

• OFAC Sanctions Search -- US Treasury Specially Designated Nationals list screening for sanctioned healthcare providers and organizations
• OpenSanctions Search -- Multi-jurisdiction watchlist screening across 100+ sanctions lists, PEP databases, and enforcement records
• CFPB Consumer Complaints -- Consumer Financial Protection Bureau complaint database revealing patient billing disputes and financial service complaints against healthcare providers
• OpenCorporates -- Global corporate registry for verifying practice entity registration, corporate structure, and ownership
• Data.gov -- Federal open data including NPI (National Provider Identifier) registry, OIG/LEIE (Office of Inspector General List of Excluded Individuals/Entities), and provider enrollment data
• Federal Register -- License enforcement actions, disciplinary proceedings, regulatory changes, and healthcare policy publications
• ORCID Researcher Search -- Open Researcher and Contributor ID database for academic identity verification and researcher profile data
• PubMed Research Search -- National Library of Medicine database of peer-reviewed biomedical publications for research credential verification

How the scoring works

The MCP produces six dimensional scores that combine into a Composite Credentialing Score (0-100).

Provider Compliance Score evaluates sanctions hits from OFAC and OpenSanctions, regulatory action density from the Federal Register, and enforcement order recency. Recent enforcement actions weight more heavily than historical ones.

Sanctions/Exclusion Risk assesses OFAC match confidence, OpenSanctions dataset breadth, and OIG/LEIE exclusion cross-reference through Data.gov. Any OIG exclusion is a critical finding requiring immediate action.

Publication Activity Index measures PubMed publication count, ORCID verification status, and research activity level. Active researchers with verified ORCID profiles and recent publications demonstrate ongoing academic engagement.

Malpractice Pattern Probability analyzes CFPB complaint frequency, Federal Register enforcement action severity, and NPDB indicator proxies from Data.gov. Multiple complaints with enforcement actions signal elevated malpractice risk.

License Verification Confidence scores NPI/DEA record matches, corporate entity status, and multi-database corroboration. Verification levels range from HIGH (multiple confirmations), MODERATE (some matches), LOW (limited data), to UNVERIFIABLE.

Credential Gap Analysis identifies missing verifications: unconfirmed ORCID identity, no peer-reviewed publications, missing corporate entity records, and incomplete license verification. Three or more gaps triggers ENHANCED_VERIFICATION_REQUIRED.

Score Range	Credentialing Level
0-25	Low risk -- strong credentials, no adverse findings
26-50	Moderate -- some gaps identified, additional documentation needed
51-75	Elevated -- significant credential gaps or compliance concerns
76-100	High risk -- sanctions matches, exclusion indicators, or critical gaps

How to connect this MCP server

Claude Desktop

Add to your claude_desktop_config.json:

{
  "mcpServers": {
    "healthcare-credentialing-intelligence": {
      "url": "https://healthcare-credentialing-intelligence-mcp.apify.actor/mcp"
    }
  }
}

Programmatic (HTTP)

curl -X POST https://healthcare-credentialing-intelligence-mcp.apify.actor/mcp \
  -H "Content-Type: application/json" \
  -H "Authorization: Bearer YOUR_APIFY_TOKEN" \
  -d '{"jsonrpc":"2.0","method":"tools/call","params":{"name":"provider_compliance_screen","arguments":{"provider":"Dr. John Smith"}},"id":1}'

This MCP also works with Cursor, Windsurf, Cline, and any other MCP-compatible client.

Use cases for healthcare credentialing intelligence

Hospital Provider Credentialing

Automate initial credentialing screening with sanctions/exclusion checks, license verification, and publication activity scoring. Identify providers requiring enhanced verification before granting privileges.

Health Insurer Network Integrity

Screen providers in your network for sanctions matches, malpractice patterns, and credential gaps. Maintain network integrity and comply with CMS requirements for excluded provider monitoring.

Locum Tenens Staffing Verification

Rapidly verify credentials for temporary and traveling healthcare providers with multi-database cross-referencing. The compare_providers tool enables side-by-side evaluation of candidates.

Ongoing Compliance Monitoring

Set up scheduled screening to detect new sanctions matches, enforcement actions, or exclusion listings for providers already in your credentialed network.

Research Credential Verification

Verify that providers claiming academic credentials have verifiable ORCID profiles and peer-reviewed PubMed publications to support their research qualifications.

Malpractice Risk Assessment

Analyze complaint patterns and enforcement action history to identify providers with elevated malpractice risk before exposure becomes liability.

How much does it cost?

This MCP uses pay-per-event pricing. You are only charged when a tool is called -- there is no subscription or monthly fee.

The Apify Free plan includes $5 of monthly platform credits, covering initial credentialing screenings at no cost.

Cost examples:

• Quick compliance screen: $2.00
• Sanctions/exclusion deep check: $2.00
• Full credentialing report (8 actors): $12.00
• Compare 3 providers: $2.00

How it works

1. You call a tool (e.g., facility_credentialing_report) with a provider name or organization
2. The MCP dispatches parallel requests to up to 8 Apify actors simultaneously
3. Sanctions lists, exclusion databases, corporate registries, NPI data, Federal Register actions, ORCID profiles, and PubMed publications are collected
4. Scoring functions compute compliance, sanctions risk, publication activity, malpractice patterns, license confidence, and credential gaps
5. A structured JSON response is returned with the composite credentialing score, verdict, dimensional analysis, and all supporting evidence

FAQ

Q: Does this verify state medical licenses directly? A: It cross-references federal databases (NPI, OIG/LEIE via Data.gov) and Federal Register regulatory actions. State-level license verification varies by jurisdiction and may require direct state board queries for authoritative confirmation.

Q: Can it detect excluded providers? A: The sanctions_exclusion_check tool screens against OFAC, OpenSanctions, and OIG/LEIE exclusion data via Data.gov. It identifies exclusion risk signals. Official NPDB clearance requires a separate NPDB query.

Q: How does provider comparison work? A: The compare_providers tool runs full credentialing analysis on 2-5 providers simultaneously, then ranks them by composite score across all dimensions for side-by-side evaluation.

Q: Does it cover nurse practitioners and allied health? A: Yes. The tools work with any healthcare provider type -- physicians, NPs, PAs, pharmacists, and allied health professionals -- by searching the same databases regardless of provider specialty.

Q: Is it legal to use this data? A: All data sources are publicly available government databases and academic registries. See Apify's guide on web scraping legality.

Q: Can I combine this with other MCPs? A: Yes. Use the Elder Care Facility Intelligence MCP for facility-level due diligence, or the Financial Crime Screening MCP for deeper AML/sanctions analysis on healthcare organizations.

Related MCP servers

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Integrations

This MCP server runs on the Apify platform and supports:

• Apify API -- Call any tool programmatically via the Apify Actor API
• Scheduling -- Set up monthly or quarterly re-screening for credentialed providers
• Webhooks -- Get notified when screenings complete for integration with credentialing management systems
• Apify integrations -- Connect to Slack, Google Sheets, Zapier, Make, and other platforms