{"uid":"cap_WaTM-g-FIRYHWlw6kIyk1","slug":"providersignal-npi-lookup-b16d67a6","name":"ProviderSignal NPI Lookup","description":"Healthcare market intelligence API. Unified provider directory + acquisition signals + license-events feed across all 50 US states, derived from NPI + state dental boards + CMS Medicare + OIG LEIE + state Medicaid + HRSA HPSA designations. All responses ship a citation envelope (`meta.envelope_version`, `meta.source_attribution`, `meta.request`) so agents can verify source freshness without out-of-band validation. Paid `/api/v1/agent/*` endpoints accept two per-call rails on a single 402: x402 (USDC on Base mainnet) and MPP (Stripe card via a Shared Payment Token), plus Bearer-token subscription auth for existing API keys. See [/docs/agent-payments](/docs/agent-payments) for the full flow. See [/docs/fields](/docs/fields) for the field glossary and [/llms.txt](/llms.txt) for the LLM crawler index.","url":"https://providersignal.com/api/v1/agent/lookup-by-npi","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET"],"type":"string"},"queryParams":{"type":"object","required":["npi"],"properties":{"npi":{"type":"string","pattern":"^\\d{10}$","description":"10-digit National Provider Identifier"}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object","required":["data","error","meta"],"properties":{"data":{"type":"object","properties":{"npi":{"type":"string"},"city":{"type":["string","null"]},"state":{"type":["string","null"]},"is_dso":{"type":"boolean"},"last_name":{"type":["string","null"]},"specialty":{"type":["string","null"]},"first_name":{"type":["string","null"]},"has_cms_claims":{"type":"boolean"},"credential_type":{"type":["string","null"]},"is_federally_excluded":{"type":"boolean"}},"description":"Full provider record. Representative fields below; see /openapi.json for the complete column list.","additionalProperties":true},"meta":{"type":"object","required":["envelope_version"],"properties":{"request":{"type":"object","properties":{"id":{"type":"string"},"endpoint":{"type":"string"},"billed_credits":{"type":"integer"},"billing_method":{"enum":["subscription","per_query","free","admin"],"type":"string"}}},"envelope_version":{"type":"string"},"source_attribution":{"type":"array","items":{"type":"object","properties":{"table":{"type":"string"},"license":{"type":"string"},"last_refresh":{"type":["string","null"]},"schema_version":{"type":"string"}}},"description":"Per-source citation: logical table, last successful refresh, schema version, license posture."}},"additionalProperties":true},"error":{"type":["object","null"],"description":"Null on success; { code, message } on failure."}}}}}}},"responseSchema":{"type":"json","example":{"data":{"npi":"1376155820","city":"BAYTOWN","state":"TX","is_dso":false,"last_name":"LEE","specialty":"General Dentist","first_name":"STACEY","has_cms_claims":true,"credential_type":"DDS","is_federally_excluded":false},"meta":{"request":{"endpoint":"/api/v1/agent/lookup-by-npi","billed_credits":1,"billing_method":"per_query"},"envelope_version":"1.0"},"error":null}},"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.5","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.5/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.5","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.5","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_oan3I4TI1OvbbE-lIGm2p","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.5","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Returns a unified healthcare provider record by 10-digit NPI, including identity, specialty, DSO affiliation, CMS claims history, and federal exclusion status.","exampleAgentPrompt":"Pull the ProviderSignal record for NPI 1376155820 — I need their specialty, DSO affiliation, whether they have CMS claims, and if they're on the federal exclusion list.","exampleUseCases":[{"title":"Verify provider before contracting","prompt":"Before we finalize this dental group acquisition, can you look up NPI 1234567890 and tell me their specialty, whether they're part of a DSO, and if they're federally excluded?"},{"title":"Enrich CRM with provider credentials","prompt":"I have a dentist's NPI — 1376155820 — can you fetch their full profile from ProviderSignal including their credential type, city, state, and whether they have Medicare claims on file?"},{"title":"Compliance screen for excluded providers","prompt":"Run an OIG exclusion and specialty check on NPI 9876543210 — I need to know if this provider is federally excluded before we add them to our network."}],"resultDescription":"A JSON object containing the provider's NPI, first and last name, city, state, specialty, credential type (e.g. DDS), DSO affiliation boolean, CMS Medicare claims boolean, federal exclusion boolean, plus a meta envelope with source attribution (NPI, CMS, OIG LEIE, etc.), last refresh timestamps, and request billing details.","failureModes":["Invalid NPI format (not 10 digits) returns a 400 validation error","NPI not found in the database returns a data null with an error object containing code and message","Expired or missing Bearer token / unpaid x402 returns 401 or 402","Payment failure on x402 or MPP rail returns 402 with payment details","Source data temporarily stale may result in outdated last_refresh timestamps in citation envelope"],"whenToPreferThis":"Choose this endpoint when you have a specific 10-digit NPI and need a single authoritative, cited provider record combining identity, specialty, DSO status, CMS history, and federal exclusion signals in one call. Prefer it over general directory search when the NPI is already known, or when compliance verification (OIG LEIE, Medicaid exclusion) is required alongside basic demographics.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T06:36:25.148Z","isFirstParty":false}