pVerify MBI Lookup API
Look up a Medicare Beneficiary Identifier for a patient from demographic data, for providers who need the MBI before they can run Medicare eligibility.
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OpenAPI Specification
openapi: 3.2.0
info:
title: pVerify MBI Lookup API
description: Real-time healthcare insurance eligibility and revenue-cycle API. Derived operation-for-operation from the public Postman collection pVerify publishes at https://postman.pverify.com/ (collection 6ceb8797-50ff-42fd-98a3-64beefaa6c94, last updated 03/01/2026). Covers eligibility (270/271), dental eligibility, insurance discovery, MBI lookup, patient demographic validation, claim status (276/277), patient cost estimation, payer lists and the CGX widget.
version: '1.0'
termsOfService: https://pverify.com/privacy-policy/
contact:
name: pVerify Support
email: support@pverify.com
url: https://pverify.com/contact-support/
servers:
- url: https://api.pverify.com
description: Production
- url: https://testapi.pverify.com
description: Test environment published by pVerify
tags:
- name: MBI Lookup
paths:
/API/MBIInquiry:
post:
operationId: mbiInquiry
tags:
- MBI Lookup
summary: MBIInquiry
description: 'MBI Skip Mechanism:
A transaction will be skipped if another transaction with same parameters(First Name, Last Name, Date of Birth (DOB), State, and SSN) is run in the current Calander month that is Processed/Processed with valid error
MBI Request Fields
Property Name |
Data Type |
Usage |
Description |
PatientSSN |
String |
Deprecated |
Patient’s SSN or HICN |
PatientSSN_or_HICN |
String |
Required |
Patient’s SSN or HICN |
PatientFirstName |
String |
Required |
Patient first name |
PatientLastName |
String |
Required |
Patient last name |
PatientDOB |
String |
Required |
Patient DOB in MM/dd/yyyy format |
ProviderLastName |
String |
Required |
Provider Last Name |
ProviderNPI |
String |
Required |
Provider NPI, format is 10 digits |
MRN |
String |
Optional |
Medical record number , 50 chars are allowed. |
Address.AddressLine1 |
String |
Optional |
Patient Street Address |
Address.City |
String |
Optional |
Patient City |
Address.State |
String |
Optional |
Patient State |
Address.ZipCode |
String |
Optional |
Patient ZipCode |'
requestBody:
required: true
content:
application/json:
schema:
type: object
properties:
ProviderLastName:
type: string
example: ProviderLastName
ProviderNPI:
type: string
example: '1234567890'
PatientFirstName:
type: string
example: John
PatientDOB:
type: string
example: 07/15/1956
PatientLastName:
type: string
example: Doe
PatientSSN_or_HICN:
type: string
PatientSSN:
type: string
MRN:
type: string
example: '1234'
Location:
type: string
Address:
type: object
properties:
AddressLine1: {}
City: {}
State:
type: string
example: MD
ZipCode: {}
example:
ProviderLastName: ProviderLastName
ProviderNPI: '1234567890'
PatientFirstName: John
PatientDOB: 07/15/1956
PatientLastName: Doe
PatientSSN_or_HICN: ''
PatientSSN: ''
MRN: '1234'
Location: ''
Address:
AddressLine1: null
City: null
State: MD
ZipCode: null
responses:
'200':
description: OK
security:
- bearerAuth: []
clientApiId: []
/API/GetMBIResponse/{requestId}:
get:
operationId: getMBIResponse
tags:
- MBI Lookup
summary: GetMBIResponse
description: 'This call is used to get the transaction result later using unique request id which is returned in MBIInquiry API call.
Sample Response
{
"RequestId": "482672",
"Status":"Processed",
"ErrorMessage": null,
"PatientSSN": "123XXXXXX",
"PatientFirstName": "PatientFirstName",
"PatientLastName": "PatientLastName",
"PatientDOB": "mm/dd/yyyy",
"MBI": "234XXXXXXXXX",
"MRN": "123435",
"PartAStatus": "Active",
"PartBStatus": "Active",
"PartADate": "02/01/2021",
"PartBDate": "02/01/2021",
"ExpiredDate": null,
"MedicareReason":"",
"APIResponseCode": 0,
"APIResponseMessage": "Processed",
"ProcessedWithError":false,
"address": {
"city": "City",
"state": "MD",
"street": "310 main",
"zip": "12345"
},
"recordCount": "1",
"score": "96"
}'
parameters:
- name: requestId
in: path
required: true
schema:
type: string
description: Unique pVerify transaction / request id returned by the matching inquiry call.
responses:
'200':
description: OK
security:
- bearerAuth: []
clientApiId: []
components:
securitySchemes:
bearerAuth:
type: http
scheme: bearer
description: 'OAuth2 access token returned by POST /Token, sent as `Authorization: Bearer <token>`.'
clientApiId:
type: apiKey
in: header
name: Client-API-Id
description: Client API identifier issued by pVerify. Required on every call; header keys are case sensitive.
clientSecret:
type: apiKey
in: header
name: Client-Secret
description: Client secret issued by pVerify, used by the one-step (no-token) endpoints and the premium report endpoints.