NPI Registry

Tools (3)

Extracted live via the executor SDK.

• npi_validate

  Validate NPI format and Luhn check digit. Instant local validation - no API call.

  WHEN TO USE:

  • ALWAYS use before npi_lookup to catch typos and save API calls
  • Validating NPI numbers from external sources (documents, forms, databases)
  • Quick format check without network dependency
  • Pre-filtering lists of NPIs before bulk lookups

  WHAT THIS CHECKS:

  1. Format: Exactly 10 digits, numeric characters only (0-9)
  2. Check digit: Valid Luhn algorithm calculation with healthcare prefix (80840)

  WHAT THIS DOES NOT CHECK:

  • Whether the NPI is actually assigned to a provider in NPPES
  • Whether the provider is active or deactivated
  • Whether the provider is licensed or credentialed
  • Whether the NPI has ever been issued

  VALIDATION RESULTS: ✓ VALID: NPI has correct format AND valid check digit -> Proceed to npi_lookup to verify assignment ✗ INVALID FORMAT: Not 10 digits or contains non-numeric characters -> Cannot be a real NPI, check for typos ✗ INVALID CHECK DIGIT: 10 digits but check digit doesn't match -> Likely a typo in one of the digits

  IMPORTANT: A valid check digit does NOT guarantee the NPI exists! Many mathematically valid NPIs have never been assigned. Use npi_lookup after validation to confirm the NPI is in NPPES.

  EXAMPLES:

  • '1234567893' -> VALID (correct format + valid check digit)
  • '123456789' -> INVALID (only 9 digits)
  • '1234567890' -> INVALID (wrong check digit, expected 3)
  • '123456789X' -> INVALID (contains non-digit character)
  • ' 1234567893 ' -> VALID (whitespace is stripped automatically)
• npi_lookup

  Get comprehensive provider details by NPI number from the CMS NPPES Registry.

  WHEN TO USE:

  • You have a specific NPI and need full provider information
  • Verifying provider credentials, specialty, or practice location
  • Following up on results from npi_search to get complete details
  • Cross-referencing clinical trial investigators with US credentials
  • Getting raw API response for advanced data extraction

  USE npi_search INSTEAD FOR:

  • Finding providers by name, location, or specialty
  • When you don't have a specific NPI number
  • Browsing providers in a geographic area

  WHAT THIS RETURNS: Basic Information:

  • Provider type: Individual (NPI-1) or Organization (NPI-2)
  • Name: Full name (individuals) or Legal Business Name (organizations)
  • Credentials: MD, DO, RN, PA-C, NP, etc. (for individuals)
  • Status: 'A' (Active) or 'D' (Deactivated)
  • Enumeration date: When the NPI was first assigned
  • Last updated: When the record was last modified

  Specialty/Taxonomy:

  • Primary taxonomy code: NUCC healthcare provider taxonomy code
  • Primary taxonomy description: Human-readable specialty name
  • License state and number: From primary taxonomy

  Location:

  • Practice address: Primary practice location with full address
  • Phone number: Practice telephone (if available)

  Advanced:

  • Raw API response: Complete NPPES data including:
    • All taxonomies (up to 15)
    • Other identifiers (state license, DEA, etc.)
    • Other practice locations
    • Authorized officials (for organizations)
    • Endpoints (health information exchange)

  NOTE: Automatically validates NPI format before API call. Returns found=false if NPI is valid but not assigned to any provider.

  IMPORTANT CAVEATS:

  • Having an NPI does NOT guarantee the provider is currently licensed
  • Provider self-reports data; NPPES does not verify accuracy
  • Deactivated providers remain in database but should not be used for billing
  • Verify credentials through state licensing boards for official confirmation
• npi_search

  Search the CMS NPPES Registry for healthcare providers by name, location, specialty, or organization.

  WHEN TO USE:

  • Finding providers by name (e.g., 'Find Dr. John Smith')
  • Finding providers by specialty (e.g., 'Cardiologists in Boston')
  • Finding organizations (e.g., 'Mayo Clinic locations')
  • Verifying clinical trial investigators have US credentials
  • Building provider networks by location or specialty
  • Finding all providers at a specific facility

  USE npi_lookup INSTEAD FOR:

  • When you already have a specific NPI number
  • Getting full details including raw API response

  SEARCH REQUIREMENTS:

  • At least one search parameter required (besides enumeration_type/country_code)
  • State cannot be the only criterion - must combine with name, specialty, or city
  • Country code alone only works for non-US countries

  WILDCARD SUPPORT (min 2 characters before *):

  • first_name: 'Jo*' matches John, Joseph, Jonathan
  • last_name: 'Smi*' matches Smith, Smithson, Smitty
  • organization_name: 'Mayo*' matches Mayo Clinic, Mayo Foundation
  • taxonomy_description: 'Cardio*' matches Cardiology, Cardiovascular Disease
  • postal_code: '212*' matches all ZIP codes starting with 212

  NAME ALIAS FEATURE (DEFAULT: ON): Automatically expands first name searches to include common nicknames:

  • Robert -> also finds Bob, Rob, Robbie, Bobby
  • William -> also finds Bill, Will, Billy, Willy
  • Elizabeth -> also finds Beth, Liz, Betty, Eliza
  • Michael -> also finds Mike, Mick, Mickey Set use_first_name_alias=false for exact match only.

  PAGINATION:

  • Maximum 200 results per request (limit parameter)
  • Skip up to 1000 records (skip parameter)
  • Maximum 1,200 total results accessible (6 requests × 200)
  • Use next_skip from response to get next page
  • Set limit=200 for comprehensive searches

  COMMON SPECIALTY SEARCHES (taxonomy_description):

  • Physicians: 'Internal Medicine', 'Family Practice', 'Cardiology', 'Oncology'
  • Surgeons: 'Orthopedic Surgery', 'General Surgery', 'Neurosurgery'
  • Mental Health: 'Psychiatry', 'Psychology', 'Clinical Social Worker'
  • Allied Health: 'Physical Therapist', 'Nurse Practitioner', 'Physician Assistant'
  • Organizations: 'General Acute Care Hospital', 'Pharmacy', 'Clinical Laboratory'

  EXAMPLES:

  • Find cardiologists in Boston: taxonomy_description='Cardiology', city='Boston', state='MA'
  • Find Dr. Smith (individual): first_name='John', last_name='Smith', enumeration_type='NPI-1'
  • Find Mayo Clinic (organization): organization_name='Mayo Clinic', enumeration_type='NPI-2'
  • Find oncologists in California: taxonomy_description='Oncology', state='CA', limit=100
  • Find all pharmacies in NYC: taxonomy_description='Pharmacy', city='New York', state='NY'
  • Find nurse practitioners in Texas: taxonomy_description='Nurse Practitioner', state='TX'
  • Exact name match: first_name='Robert', use_first_name_alias=false