Medicare opt-out
CMS's Medicare opt-out affidavits by NPI: specialty, opt-out effective and end dates, and whether the provider may order and refer.
| Source | CMS (Opt Out Affidavits) |
| Source id | cms-opt-out |
| Release cadence | About monthly |
| License | Public domain (US government work) |
| Endpoint | /v1/providers/{npi}/opt-out |
| MCP tool | check_medicare_opt_out |
| Plans | Every plan, Free included |
Providers who opt out of Medicare file an affidavit with their Medicare contractor; CMS publishes the list. Each record is one affidavit: NPI, name, specialty, opt-out effective and end dates, whether CMS lists the provider as eligible to order and refer, the practice address on the affidavit and when CMS last updated it.
curl https://api.healthcare.dev/v1/providers/1720444581/opt-out \
-H "Authorization: Bearer $HDEV_API_KEY"opted_outis true when a listed affidavit's period covers today (effective on or before today, ending after it). An NPI can have affidavits in several states.- Opt-outs renew every two years unless the provider cancels, so
opt_out_end_datemoves when one renews. - Not listed means no opt-out affidavit recorded with this NPI as of
data_version. Affidavits a later file drops stay withstatus: retired. GET /v1/providers/{npi}links here (links.opt_out) when the file lists the NPI.
Medicare enrollment (PECOS)
CMS's public Medicare fee-for-service provider enrollment file by NPI: enrollment id, PECOS associate id, provider type and enrollment state.
OIG exclusions (LEIE)
The HHS OIG List of Excluded Individuals/Entities: exclusions recorded with an NPI, and a name search, with exclusion type, dates and reinstatements.