Check Provider Exclusion
check_provider_exclusionIs this healthcare provider barred from Medicare, Medicaid and other federal health programs? Screens a person or business name — or an NPI — against the HHS OIG List of Excluded Individuals/Entities, the list you are required to check before paying, employing or contracting with a provider. Answers "is Dr X excluded", "check this provider against the OIG exclusion list", "has this practice been barred from Medicare", and pre-payment or credentialing screening. Returns matching exclusions with the date of birth, state, city, specialty and NPI that tell same-named people apart, plus when the exclusion started and the statutory reason for it, and a match_confidence saying what was actually matched. Never returns a bare yes/no: several excluded people can share a name, so identifying the right one is the caller's job and this gives them what they need to do it. Pass npi to turn a name lead into an identification. Sourced from HHS OIG.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| npi | No | The provider's 10-digit NPI, if you have it. An NPI match is an identification rather than a name lead — always pass it when known. | |
| name | No | Provider or business name to screen, e.g. "John Smith" or "Acme Home Health". Any order; surname-first works too. | |
| limit | No | Maximum candidates to return (default 10, max 50). | |
| state | No | Two-letter state code to narrow candidates, e.g. "CA". Useful when a common name returns several people. |