Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?
With no annotations, the description carries the full burden, and it does disclose the scope of checks performed (registry, taxonomy, location, LEIE exclusion). It says nothing about read-only nature being guaranteed, behavior on an invalid or unassigned NPI, partial-match handling, rate limits, or whether all four checks always run.
Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.