{
"code": "400",
"message": "Invalid NPI number format."
}
{
"code": "401",
"message": "Unauthorized"
}
{
"code": "403",
"message": "pro tier required to access this model"
}
{
"code": "404",
"message": "No practitioner found for the given NPI number"
}
{
"code": "422",
"message": "NPI number must correspond to an individual (NPI-1)"
}
{
"code": "429",
"message": "Too Many Requests"
}
{
"code": "500",
"message": "Unexpected server error"
}
Returns information about the practitioner associated with the provided NPI number.The response includes:
Specialties: reported by NPPES
Referral scope matches: our estimate of whether the provider is an appropriate candidate for a routine referral for a specific performable or procedure — see the referral scope match methodology
Practice locations: reported by CMS National Provider Database, Doctors and Clinicians National Downloadable File, NPPES, and public health plan network directories
Geocoding: coordinates for the location’s address, when available
Stale affiliation risk: our estimate of whether the practitioner is actually seeing patients at this location — see the stale location methodology
Bookability: our estimate of whether a patient can book an appointment with the practitioner at this location — see the stale location methodology
A non-match (unlikely_match or very_unlikely_match) means a routine referral target does not fit the provider’s observed billing. It does not mean the service is outside their scope of practice or that they are unqualified; it reflects what they routinely bill, not what they are licensed or trained to do.
This endpoint serves individual practitioners (NPI-1) only.
The 10-digit number corresponding to NPPES registration for the practitioner of interest. Must also correspond to NPI Type Individual (NPI-1) - see https://npiregistry.cms.hhs.gov/help/help-home for more information.
The version of the practitioner location risk model to use, as enumerated by GET /models. Governs both staleAffiliationRisk and bookability, which come from one model and are versioned together. Defaults to the latest version if omitted.
An array of locations that the practitioner practices at, as reported by the CMS National Provider Database, the Doctors and Clinicians National Downloadable File, NPPES, and public health plan network directories.
The version of each model whose output appears in this response. Always present; a key appears only when that model was served for this request, so an absent key means that model contributed nothing to the response. Use these values to record exactly which model versions a response was based on.
One estimate per routine referral target evaluated for this practitioner. Each entry pairs a target with a label describing how well the practitioner fits it as a destination, derived from observed Medicare and Medicaid billing rather than from what their license or self-reported specialty permits. Present only when the referral scope match model was served for this request, as reported by servedModels.referralScopeMatch; empty when the model was served but produced no estimates for this practitioner.