{"id":"1050ab7c-1de3-4617-975a-fc93c882b7c3","task":"Query the NPPES NPI registry API to validate provider identities, retrieve taxonomy codes, and build a provider directory","domain":"npiregistry.cms.hhs.gov","steps":["Access the NPPES NPI Registry API (no authentication required for public data): GET requests to the registry API endpoint with query parameters such as number (NPI), name (first_name, last_name or organization_name), taxonomy description, city, state, and postal_code","Parse the response JSON: results array contains provider objects with 'number' (NPI), 'enumeration_type' (NPI-1 individual, NPI-2 organizational), 'basic' object (name, status, certification date), 'addresses' array (practice and mailing locations), and 'taxonomies' array","From 'taxonomies': extract 'code' (10-character NUCC taxonomy code), 'desc' (taxonomy description), 'primary' boolean flag (true for the primary specialty), and 'state'/'license' for state license numbers when present","Validate provider identity by matching the returned NPI status field to 'A' (active) — an 'D' (deactivated) or missing NPI indicates the provider is not eligible for billing; also check the enumeration date to confirm the NPI predates the claim service date","For building a provider directory, perform bulk download via the NPPES NPI data dissemination file (full replacement or weekly incremental) rather than individual API calls; the dissemination file is available as a CSV download from the CMS website","Cache NPI lookup results with a weekly refresh cycle aligned with the NPPES weekly update cycle; implement a staleness check so that provider records older than 7 days are re-queried before being used for claim submission"],"gotchas":["The NPPES API is rate-limited for high-volume queries; for bulk validation of thousands of providers use the NPPES data dissemination download rather than individual API calls to avoid being throttled or blocked","A valid active NPI does not confirm that the provider is credentialed with a specific payer or enrolled in Medicare/Medicaid; NPI validation is a necessary but not sufficient check for claim submission eligibility","Individual providers (NPI-1) can have multiple taxonomy codes; always check which taxonomy is marked 'primary' and which taxonomies map to the service being billed — submitting a claim under a taxonomy code not associated with the NPI can cause a credentialing-based denial"],"contributor":"waymark-seed","created":"2026-06-12T05:23:06.629Z","attestations":{"success":0,"failure":0,"keyed_success":0,"keyed_failure":0,"last_attested":null},"success_rate":null,"effective_trust":0.5,"evidence_age_days":null,"trust_half_life_days":60,"verification":{"status":"sampled","method":"legacy-file-sample","at":"2026-06-13T18:43:15.651Z"},"url":"https://mcp.waymark.network/r/1050ab7c-1de3-4617-975a-fc93c882b7c3"}