Free Tool · Credentialing

Free NPI and Medicare Enrollment Check

Enter one NPI. See its NPPES record next to the CMS public Medicare files, with the source and date on every line and plain notes on what each result means.

This free check reads one NPI against the NPPES NPI Registry and the CMS public Medicare files on data.cms.gov, then shows what each source lists for it today: NPI type and status, the name and addresses on the NPPES record, whether the NPI appears in the CMS public enrollment file, its revalidation due date, any opt-out affidavit, and its order and referring listing.

Use it before a Medicare or payer application goes out, when a new provider joins the group, or when claims start coming back with enrollment denials. The result is free and on this page; no sign-up is needed to see it. Public provider data only, so do not enter any patient information.

Where every line comes from

Public sources only. Each result names its source, links to it, and shows when it was read.

NPPES NPI Registry

NPI type, active or deactivated, the name on the record, taxonomy codes, practice and mailing addresses, and the date NPPES last updated the record.

Medicare Fee-For-Service Public Provider Enrollment (data.cms.gov)

Whether a row for this NPI appears in the CMS public enrollment file, with the state and provider type it lists.

Medicare Revalidation Due Date List (data.cms.gov)

The revalidation due date CMS publishes for the NPI, or "TBD" when CMS has not set one.

Medicare Opt-Out Affidavits (data.cms.gov)

Whether an opt-out affidavit is on the CMS public list for the NPI.

Medicare Order and Referring (data.cms.gov)

Whether the NPI is listed as eligible to order and refer for Medicare.

What this check does not cover

Said plainly, so a clean result is not read as more than it is.

OIG exclusions (LEIE). Search the OIG exclusions database yourself before hiring or filing.
Medicaid. Each state runs its own enrollment; see Medicaid provider enrollment by state.
State licensing boards. License status comes from the board in each state where the provider practices.
Commercial payers. Aetna, UnitedHealthcare, Cigna, Blue Cross plans and others keep their own files; how to ask each one is in how to check credentialing status.
CAQH. The profile and its attestation live behind the provider's own login; see what CAQH is.
An application in progress. Public files show what CMS has published, not where a pending application sits with a Medicare contractor or any other payer.

For what CMS's systems are and how they relate, see what PECOS is and NPI Type 1 vs Type 2. The full document list for an application is on what we need from you.

How to read the result

Nothing flagged in the public records we read

Every source answered and none of them raised an item to look at. It describes the public files on the day of the check, nothing more.

Items to review

At least one source shows something worth a look before an application goes out: a deactivated NPI, a mailing address standing in for a practice address, no row in the CMS public enrollment file, a revalidation date, an opt-out affidavit.

No NPPES record for this NPI

The number passes the check-digit test but NPPES returned no record. Re-check the digits against the NPI letter or the provider’s NPPES account.

NPI Registry did not answer

NPPES timed out or returned an error, so nothing else can be read against it. Try again in a few minutes.

NPI and Medicare check questions, answered

What does this free NPI check look at?

One NPI, read against public data: the NPPES NPI Registry (type, status, name, taxonomy, practice and mailing addresses, last update) and four CMS public Medicare files from data.cms.gov (fee-for-service enrollment, revalidation due dates, opt-out affidavits, order and referring). Each result line names its source and links to it.

If the NPI is not found in the CMS public enrollment file, does that mean Medicare will not pay?

No. The public file is a periodic CMS extract, it trails the Medicare contractor’s own system, and it leaves out some enrollment types. A miss is a reason to look in PECOS or ask the Medicare contractor, not a conclusion about the provider’s Medicare status.

What does this check not cover?

OIG exclusions, Medicaid in any state, state licensing boards, commercial payers, CAQH, and the status of any application a payer is still processing. Those each have their own source; the page lists where to look for each.

Do I have to give an email address to see the result?

No. The result appears on the page for anyone who enters an NPI. An email address is asked for only if you choose to send the readout to a credentialing specialist.

Is an NPI public information?

Yes. CMS publishes NPPES records and the Medicare enrollment, revalidation, opt-out and order/referring files for anyone to read. This check asks for no patient information and none is needed.

What does ClaimCarePro charge if I want help after the check?

The check is free. If you want us to file, ClaimCarePro charges $250 per payer application per provider, or $1,750 per provider for the new-practice bundle.

Want us to file it?

Flat, published prices. Weekly payer follow-up, logged, on every application.

ClaimCarePro files payer applications for $250 per payer application per provider. The new-practice bundle is $1,750 per provider. Our team brings 30+ years of combined billing and credentialing experience. Details are on provider credentialing services.

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Prefer to talk first? Call (844) 772-8902 or book a 15-minute call.

Last updated November 5, 2026. Public data only; this check is not legal advice.