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GET
Get practitioner by NPI number
Returns information about the practitioner associated with the provided NPI number. The response includes:
  • Specialties: reported by NPPES
  • Referral scope matches: proprietary information about whether the provider is an appropriate candidate for a routine referral for a specific performable or procedure
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.

Authorizations

Authorization
string
header
required

Bearer authentication header of the form Bearer <token>, where <token> is your API token.

Path Parameters

npiNumber
string
required

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.

Required string length: 10
Pattern: ^[0-9]{10}$

Query Parameters

model
string
default:latest

The desired model to use.

Response

Expected response to a valid request

name
string
required

The name of the practitioner, as reported by NPPES.

nppesSpecialties
string[]
required

An array of NUCC Provider Taxonomy codes (https://www.nucc.org/index.php/code-sets-mainmenu-41/provider-taxonomy-mainmenu-40) for the practitioner, as reported by NPPES.

referralScopeMatches
object[]
required

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.