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openapi: 3.2.0
info:
description: API for Certify application
title: Certify API Layer Npi Validation API
version: 1.0.0
servers:
- url: http://localhost:9000
description: Local Development Server
- url: https://api-service.staging.certifyos.com
description: Staging Server
- url: https://api-service.internal.certifyos.com
description: Internal Server
- url: https://api-service.test.certifyos.com
description: Test Server
- url: https://api-service.demo.certifyos.com
description: Demo Server
- url: https://api-service.certifyos.com
description: Production Server
tags:
- name: NpiValidation
description: NPI validation operations
paths:
/npi/validate:
post:
summary: Validate NPI
description: Validates the NPI format (Luhn checksum), then checks the CertifyOS DAL (sourceType=nppes) using the declared entity type to route to the correct core resource API. Falls back to the live NPPES public registry if not found. 'entityType' is an optional query parameter (case-insensitive); defaults to practitioner when omitted. Status VALID_FOUND_IN_NPPES_BUT_FAILED_CROSSWALK_CREATION indicates the NPI was found in NPPES but the DAL crosswalk upsert failed.
operationId: validateNpi
tags:
- NpiValidation
parameters:
- description: 'Entity type of the NPI: practitioner, facility, or group. Case-insensitive. Defaults to PRACTITIONER when omitted. Returns 400 if an unrecognised value is supplied.'
example: facility
name: entityType
in: query
schema:
type: string
- name: tenant-id
in: header
schema:
type: string
requestBody:
description: Request object containing the NPI to validate
content:
application/json:
schema:
$ref: '#/components/schemas/NpiValidationRequest'
required: true
responses:
'200':
description: NPI is valid and found. Status is VALID_AND_FOUND (found in DAL), VALID_FOUND_IN_NPPES (found in live NPPES registry and crosswalk succeeded), or VALID_FOUND_IN_NPPES_BUT_FAILED_CROSSWALK_CREATION (found in live NPPES registry but DAL crosswalk upsert failed).
content:
application/json:
schema:
$ref: '#/components/schemas/NpiValidationResponse'
'400':
description: 'Bad Request - Malformed request body (missing or null npi field) or unrecognised entityType query parameter value (accepted: practitioner, facility, group — case-insensitive)'
content:
application/json:
schema:
$ref: '#/components/schemas/NpiValidationErrorResponse'
'401':
description: Unauthorized - Authentication required
'403':
description: Forbidden - Insufficient permissions
'404':
description: Not Found - NPI is valid but not found in the DAL or the NPPES registry
content:
application/json:
schema:
$ref: '#/components/schemas/NpiValidationErrorResponse'
'422':
description: Unprocessable Entity - NPI format is invalid (Luhn check failed), or the declared entityType does not match the enumeration type returned by NPPES (e.g. FACILITY declared but NPI is registered as a Type 1 individual provider)
content:
application/json:
schema:
$ref: '#/components/schemas/NpiValidationErrorResponse'
'503':
description: Service Unavailable - Live NPPES registry fallback is disabled by configuration (NPI_VALIDATION_NPPES_ENABLED is set to false)
content:
application/json:
schema:
$ref: '#/components/schemas/NpiValidationErrorResponse'
security:
- jwt: []
components:
schemas:
CoreFacilitydataschemaLicensesInner:
type: object
properties:
type:
type: string
expirationDate:
$ref: '#/components/schemas/Date'
issueDate:
$ref: '#/components/schemas/Date'
licenseNumber:
type: string
state:
type: string
licenseType:
type: string
licenseStatus:
type: string
licenseSource:
type: string
reportDate:
$ref: '#/components/schemas/Date'
licenseNumberVariations:
type: string
flaggedDate:
$ref: '#/components/schemas/Date'
dataSource:
type: string
url:
type: string
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/FacilityAttachment'
verifiedDate:
$ref: '#/components/schemas/Date'
verifiedBy:
type: string
CorePractitionerdatabaseschemaNppesInnerTaxonomiesInner:
type: object
properties:
code:
type: string
desc:
type: string
license:
type: string
primary:
type: boolean
state:
type: string
taxonomyGroup:
type: string
FacilityBusinessPurposeIsForMonitoring:
type: object
properties:
value:
type: boolean
reason:
type: string
CorePractitionerdatabaseschemaMedicareInner:
type: object
properties:
medicareNumber:
type: string
medicareState:
type: string
issueDate:
$ref: '#/components/schemas/Date'
expirationDate:
$ref: '#/components/schemas/Date'
source:
type: string
url:
type: string
reportDate:
$ref: '#/components/schemas/Date'
flaggedDate:
$ref: '#/components/schemas/Date'
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
verifiedDate:
$ref: '#/components/schemas/Date'
verifiedBy:
type: string
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
Attachment1:
type: object
properties:
createdAt:
$ref: '#/components/schemas/Date'
fileType: {}
fileUrl:
type: string
originalFileName:
type: string
state: {}
expirationDate: {}
source: {}
createdBy: {}
credWorkflowRecordOrigin:
type: string
NpiValidationRequest:
description: Request to validate an NPI
type: object
required:
- npi
properties:
npi:
type: string
description: The NPI to validate
examples:
- '1234567890'
PractitionerRolesMapValue:
type: object
properties:
effectiveDate:
$ref: '#/components/schemas/Date'
terminationDate:
$ref: '#/components/schemas/Date'
Date:
type: string
format: date
CorePractitionerdatabaseschemaLicensureActionsInner:
type: object
properties:
licenseNumber:
type: string
details:
type: string
state:
type: string
lastActionDate:
$ref: '#/components/schemas/Date'
reportDate:
$ref: '#/components/schemas/Date'
source:
type: string
actionType:
type: string
verifiedBy:
type: string
verifiedDate:
$ref: '#/components/schemas/Date'
createdDate:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
dataAcquireDate:
$ref: '#/components/schemas/Date'
flaggedDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
url:
type: string
credWorkflowRecordOrigin:
type: string
CorePractitionerdatabaseschemaWorkHistoryGapsInner:
type: object
properties:
explanation:
type: string
gapStartDate:
$ref: '#/components/schemas/Date'
gapEndDate:
$ref: '#/components/schemas/Date'
verifiedDate:
$ref: '#/components/schemas/Date'
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
CorePractitionerdatabaseschemaBoardCertificationsInner:
type: object
properties:
abmsId:
type: string
certificateId:
type: string
certifyingBoardName:
type: string
isPrimary:
type: boolean
certificateType:
type: string
durationType:
type: string
expireDate:
$ref: '#/components/schemas/Date'
expirationDate:
$ref: '#/components/schemas/Date'
issueDate:
$ref: '#/components/schemas/Date'
reverificationDate:
$ref: '#/components/schemas/Date'
speciality:
type: string
subspeciality:
type: string
verifiedBy:
type: string
verifiedDate:
$ref: '#/components/schemas/Date'
moc:
type: string
status:
type: string
occuranceType:
type: string
recordType:
type: string
reportDate:
$ref: '#/components/schemas/Date'
flaggedDate:
$ref: '#/components/schemas/Date'
source:
type: string
city:
type: string
state:
type: string
zipCode:
type: string
country:
type: string
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
CorePractitionerdatabaseschemaPhoneNumbersInner:
type: object
properties:
phoneNumber:
type: string
faxNumber:
type: string
type:
type: string
source:
type: string
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
credWorkflowRecordOrigin:
type: string
CoreFacilitydataschemaNppesInnerAddressesInner:
type: object
required:
- address1
- addressType
- city
- countryCode
- countryName
- state
properties:
address1:
type: string
addressPurpose:
type: string
addressType:
type: string
city:
type: string
countryCode:
type: string
countryName:
type: string
faxNumber:
type: string
postalCode:
type: string
state:
type: string
telephoneNumber:
type: string
CorePractitionerdatabaseschemaEducationTrainingInner:
type: object
properties:
startDate:
$ref: '#/components/schemas/Date'
endDate:
$ref: '#/components/schemas/Date'
type:
type: string
degree:
type: string
speciality:
type: string
subspecialty:
type: string
institution:
type: string
licensingBoardReference:
type: string
verifiedBy:
type: string
verifiedDate:
$ref: '#/components/schemas/Date'
status:
type: string
source:
type: string
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
CoreFacilitydataschemaMedicareStarRatingsInner:
type: object
properties:
starRating:
type: string
reportDate:
$ref: '#/components/schemas/Date'
source:
type: string
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/FacilityAttachment'
verifiedDate:
$ref: '#/components/schemas/Date'
verifiedBy:
type: string
CorePractitionerdatabaseschemaMalpracticeInsuranceInner:
type: object
properties:
carrierName:
type: string
expiryDate:
$ref: '#/components/schemas/Date'
effectiveDate:
$ref: '#/components/schemas/Date'
flaggedDate:
$ref: '#/components/schemas/Date'
source:
type: string
status:
type: string
policyNumber:
type: string
aggregateCoverageAmount:
type: string
occuranceCoverageAmount:
type: string
verifiedBy:
type: string
verifiedDate:
$ref: '#/components/schemas/Date'
type:
type: string
unlimitedCoverage:
type: boolean
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
NppesEntry:
type: object
description: NPPES entry for a GROUP NPI lookup
properties:
npi:
type: string
description: NPI number
examples:
- '1023950565'
active:
type: boolean
description: Whether the record is active in NPPES
examples:
- true
firstName:
type: string
examples:
- PAMELA
middleName:
type: string
examples:
- S
lastName:
type: string
examples:
- COKER
prefix:
type: string
examples:
- ''
suffix:
type: string
examples:
- ''
credential:
type: string
examples:
- ''
gender:
type: string
examples:
- ''
enumerationDate:
type: string
description: Date NPI was enumerated (YYYY-MM-DD)
examples:
- '2026-04-06'
lastUpdatedAt:
type: string
description: Date record was last updated in NPPES (YYYY-MM-DD)
examples:
- '2026-04-06'
certificationDate:
type: string
description: Certification date (YYYY-MM-DD)
examples:
- '2026-04-06'
enumerationType:
type: string
description: 'NPPES enumeration type: 1=individual, 2=organization'
examples:
- '2'
organizationId:
type: string
description: Organization name associated with this GROUP NPI
examples:
- ELEVATE ILLINOIS HOME CARE LLC
addresses:
type: array
items:
$ref: '#/components/schemas/Address'
description: Mailing and practice addresses for this entry
taxonomies:
type: array
items:
$ref: '#/components/schemas/Taxonomy'
description: Taxonomy classifications
identifiers:
type: array
items: {}
description: Other identifiers (e.g. state licence IDs)
id:
type: string
examples:
- ''
providerId:
type: string
examples:
- ''
createdBy:
type: string
examples:
- ''
createdByName:
type: string
examples:
- ''
createdAt:
type: string
examples:
- ''
updatedBy:
type: string
examples:
- ''
updatedAt:
type: string
examples:
- ''
status:
type: string
examples:
- ''
verifiedAt:
type: string
examples:
- ''
verifiedBy:
type: string
examples:
- ''
verifiedDate:
type: string
examples:
- ''
verifiedByName:
type: string
examples:
- ''
source:
type: string
examples:
- ''
credWorkflowRecordOrigin:
type: string
examples:
- ''
otherNames:
type: array
items: {}
description: Alternate names on record
CorePractitionerdatabaseschemaNpdbReportsInner:
type: object
properties:
ssn:
type: string
birthdate:
$ref: '#/components/schemas/Date'
flaggedDate:
$ref: '#/components/schemas/Date'
licensureField:
type: string
reportDate:
$ref: '#/components/schemas/Date'
processDate:
$ref: '#/components/schemas/Date'
verifiedBy:
type: string
data: {}
verifiedDate:
$ref: '#/components/schemas/Date'
typeOfAction:
type: string
createdDate:
$ref: '#/components/schemas/Date'
deceased:
type: string
paymentAmount:
type: string
paymentDate:
$ref: '#/components/schemas/Date'
patientAge:
type: string
patientGender:
type: string
patientType:
type: string
medicalConditionDescription:
type: string
procedureDescription:
type: string
allegationsDescription:
type: string
allegationNature:
type: string
specificAllegation:
type: string
specificAllegationDate:
$ref: '#/components/schemas/Date'
outcome:
type: string
source:
type: string
reportType:
type: string
firstName:
type: string
lastName:
type: string
middleName:
type: string
gender:
type: string
npi:
type: string
homeAddress:
type: string
homeCity:
type: string
homeState:
type: string
homeZip:
type: string
dcn:
type: string
reportDCN:
type: string
notes:
type: array
items:
type: string
maintainedUnder:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaNpdbReportsInnerMaintainedUnder'
correctedFields:
type: array
items:
type: string
previousDCN:
type: string
previousTransaction:
type: string
databankSubjectId:
type: string
minLength: 1
otherName:
type: array
items:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaNpdbReportsInnerOtherNameInner'
certification:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaNpdbReportsInnerCertification'
submitter:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaNpdbReportsInnerSubmitter'
enrollmentStatus:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaNpdbReportsInnerEnrollmentStatus'
transactionTypeCode:
type: string
transactionType:
type: string
recentChangeDate:
$ref: '#/components/schemas/Date'
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
CorePractitionerdatabaseschemaNpdbReportsInnerEnrollmentStatus:
type: object
properties:
dataBank:
type: string
status:
type: string
statusCode:
type: string
section1128e:
type: boolean
section1921:
type: boolean
titleIV:
type: boolean
startDate:
$ref: '#/components/schemas/Date'
endDate:
$ref: '#/components/schemas/Date'
MdmErrorDetail:
type: object
properties:
code:
type: string
message:
type: string
failedStep:
type: string
CorePractitionerdatabaseschemaCaqhPdqsPractitionerProfessionalIdPractitionerEcfmg:
type: object
properties:
ecfmgNumber:
type: string
ecfmgIssueDate:
$ref: '#/components/schemas/Date'
DelegationStatusEnum1:
type: string
enum:
- Delegated
- Direct
CoreFacilitydataschemaSanctionsInner:
type: object
properties:
dateOfReport:
$ref: '#/components/schemas/Date'
sanctionType:
type: string
typeOfAction:
type: string
data:
type: string
flaggedDate:
$ref: '#/components/schemas/Date'
source:
type: string
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/FacilityAttachment'
verifiedDate:
$ref: '#/components/schemas/Date'
verifiedBy:
type: string
PractitionerMedicaidInner:
type: object
properties:
state:
type: string
medicaidNumber:
type: string
medicaidState:
type: string
cdsNumber:
type: string
issueDate:
$ref: '#/components/schemas/Date'
expirationDate:
$ref: '#/components/schemas/Date'
source:
type: string
url:
type: string
reportDate:
$ref: '#/components/schemas/Date'
flaggedDate:
$ref: '#/components/schemas/Date'
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
verifiedDate:
$ref: '#/components/schemas/Date'
verifiedBy:
type: string
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
NpiValidationErrorResponse:
description: Error response for NPI validation
type: object
properties:
status:
type: integer
format: int32
description: HTTP status code
examples:
- 400
error:
type: string
description: Error type
examples:
- Bad Request
message:
type: string
description: Detailed error message
examples:
- Request body must be a valid JSON object with a non-null 'npi' field.
CoreFacilitydataschemaPerformanceIndicatorsInner:
type: object
properties:
totalComplaints:
type: integer
format: int32
clinicalComplaints:
type: integer
format: int32
serviceComplaints:
type: integer
format: int32
benefitsComplaints:
type: integer
format: int32
claimComplaints:
type: integer
format: int32
accessIssueComplaints:
type: integer
format: int32
reportDate:
$ref: '#/components/schemas/Date'
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/FacilityAttachment'
verifiedDate:
$ref: '#/components/schemas/Date'
verifiedBy:
type: string
CorePractitionerdatabaseschemaNpdbReportsInnerCertificationPhone:
type: object
properties:
number:
type: string
Taxonomy:
type: object
description: Taxonomy classification for a GROUP NPI entry
properties:
code:
type: string
description: NUCC taxonomy code
examples:
- 253Z00000X
desc:
type: string
description: Human-readable taxonomy description
examples:
- ''
license:
type: string
examples:
- ''
primary:
type: boolean
description: Whether this is the primary taxonomy
examples:
- true
state:
type: string
examples:
- ''
taxonomyGroup:
type: string
examples:
- ''
CoreFacilitydataschemaNppesInnerTaxonomiesInner:
type: object
required:
- code
- desc
properties:
code:
type: string
desc:
type: string
license:
type: string
primary:
type: boolean
state:
type: string
taxonomyGroup:
type: string
CorePractitionerdatabaseschemaNpdbReportsInnerCertification:
type: object
properties:
name:
type: string
title:
type: string
phone:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaNpdbReportsInnerCertificationPhone'
date:
$ref: '#/components/schemas/Date'
CorePractitionerdatabaseschemaDeaInner:
type: object
properties:
expireDate:
$ref: '#/components/schemas/Date'
expirationDate:
$ref: '#/components/schemas/Date'
affiliation:
type: string
deaNumber:
type: string
number:
type: string
cdsLicenseNumber:
type: string
state:
type: string
providerType:
type: string
verifiedBy:
type: string
verifiedDate:
$ref: '#/components/schemas/Date'
source:
type: string
type:
$ref: '#/components/schemas/TypeEnum'
status:
type: string
reportDate:
$ref: '#/components/schemas/Date'
flaggedDate:
$ref: '#/components/schemas/Date'
url:
type: string
createdAt:
$ref: '#/components/schemas/Date'
createdBy:
type: string
updatedAt:
$ref: '#/components/schemas/Date'
updatedBy:
type: string
attachments:
type: array
items:
$ref: '#/components/schemas/Attachment1'
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
credWorkflowRecordOrigin:
type: string
CorePractitionerdataschema:
type: object
properties:
caqhPdqs:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaCaqhPdqs'
prefix:
type: string
firstName:
type: string
caqhPrimaryEmail:
type: string
middleName:
type: string
lastName:
type: string
suffix:
type: string
primaryEmail:
type: string
npi:
type: string
externalId:
type: string
enrollmentStartDate:
$ref: '#/components/schemas/Date'
reimbursementId:
type: string
supervisingPractitionerId:
type: string
caqhProviderId:
type: string
providerType:
type: array
items:
type: string
practitionerType:
type: array
items:
type: string
practitionerSpecializedTraining:
type: array
items:
type: string
practitionerTypesToCredential:
type: array
items:
type: string
reviewCompleteDate:
$ref: '#/components/schemas/Date'
statesToCredential:
type: array
items:
type: string
practitionerRoles:
type: array
items:
type: string
practitionerRolesMap:
type: object
additionalProperties:
$ref: '#/components/schemas/PractitionerRolesMapValue'
lineOfBusiness:
type: array
items:
type: string
providerId:
type: string
dateOfBirth:
$ref: '#/components/schemas/Date'
ssn:
type: string
gender:
type: string
race:
type: string
ethnicity:
type: string
providerCreatedDate:
$ref: '#/components/schemas/Date'
npdbDatabankSubjectId:
type: string
npdbDcn:
type: string
isDeceased:
type: boolean
deceasedDate:
$ref: '#/components/schemas/Date'
deceasedExplanation:
type: string
lastCredentialedDate:
$ref: '#/components/schemas/Date'
lastCredentialingDate:
$ref: '#/components/schemas/Date'
nextCredentialingDate:
$ref: '#/components/schemas/Date'
initialCredentialingDate:
$ref: '#/components/schemas/Date'
dataAcquireDate:
$ref: '#/components/schemas/Date'
sourceUpdateDate:
$ref: '#/components/schemas/Date'
emails:
type: array
items:
$ref: '#/components/schemas/CorePractitionerdatabaseschemaEmailsI
# --- truncated at 32 KB (85 KB total) ---
# Full source: https://raw.githubusercontent.com/api-evangelist/certifyos/refs/heads/main/openapi/certifyos-npivalidation-api-openapi.yml