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health.provider-profile

Retrieve merged provider identity, industry payments, and Medicare billing data from one NPI query. Supports due diligence and fraud checks.

Instructions

Provider 360 by NPI — merges NPPES identity (name, specialty, address, licenses) + CMS Open Payments (industry payments) + CMS Medicare billing in one call. Each section reports found/error independently. KYC, healthcare-fraud, provider due diligence.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
npiYes10-digit National Provider Identifier.
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

No annotations provided, so description must carry behavioral disclosure. It mentions independent error reporting per section ('Each section reports found/error independently'), which adds value. However, it omits details like rate limits, authorization requirements, or return structure (e.g., pagination).

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Two sentences with no wasted words. First sentence describes core functionality and data sources; second sentence adds error handling details and use cases. Front-loaded and efficient.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a simple lookup with one parameter and no output schema, the description provides adequate context (data sources, independent error handling, use cases). Lacks return structure details but sufficient given low complexity.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema coverage is 100% for the single parameter 'npi' with description '10-digit National Provider Identifier.' The description adds minimal extra meaning beyond referencing 'by NPI'. Baseline 3 is appropriate as schema already documents the parameter.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

Description explicitly states it merges NPPES identity, CMS Open Payments, and CMS Medicare billing data into one call, using a specific verb ('merges') and resource ('Provider 360 by NPI'). It distinguishes from sibling tools like health.medicare-provider and health.open-payments by offering a comprehensive profile.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Clear context for use cases (KYC, healthcare-fraud, provider due diligence) but lacks explicit when-not-to-use or comparisons with alternative tools. The description implies it's the go-to for comprehensive provider data.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

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