USE CASE · CREDENTIALING & PROVIDER-DATA ENRICHMENT
Credential against the federal record — not a stale directory.
Enrich every provider with identity, taxonomy, enrollment, and quality data drawn from NPPES, PECOS, and CMS — each field stamped with its source and snapshot date, and reproducible as it stood on any past date.
providers PECOS enrollmentsPer-field provenancePoint-in-time history
✓ No PHI✓ Field-level source✓ As-of any date✓ JSON + CSV
The credentialing burden
Re-checking a directory you cannot date.
Provider directories drift the moment they are published — a taxonomy changes, an enrollment lapses, an address moves. Credentialing and re-credentialing means re-checking each field against the primary source, and a directory accuracy review cannot tell you when a field was last true. That gap is exactly what payer directory-accuracy enforcement penalizes.
Fonteum re-derives each field from the federal source and stamps the snapshot date on it — so a field is never ambiguously current, and a re-credentialing file can show the exact record relied on at decision time.
The developer pain
Joining four files by hand, then losing the lineage.
NPPES, PECOS, QPP, and the exclusion lists are four different files on four refresh cadences with no shared key beyond the NPI. Stitching them yourself means a brittle ETL job — and once joined, the lineage of which source produced which field is gone.
One GET by NPI returns every field already joined, each carrying its own source, snapshot date, and confidence. The join, the freshness, and the provenance are the response — not something you reconstruct downstream.
How it works
The sources joined, and how a field is stamped.
NPPES
Identity & taxonomy
Legal name, NPI, primary and secondary taxonomy, practice address — re-derived from the CMS NPI Registry on its release schedule.
PECOS
Medicare enrollment
Enrollment status and reassignment, joined by NPI. The signal a credentialing team checks to confirm a provider can bill Medicare.
QPP
Quality signal
CMS MIPS final score where present — a federally reported quality measure attached to the provider, not a Fonteum opinion.
LEIE
Exclusion flag
An OIG / SAM exclusion flag rides on the same record, so a screen and an enrichment are a single call.
Integration & workflow
One record. Two ways in.
Developers fetch a provider by NPI over REST. Credentialing teams reconcile a roster and export the enriched record. Same data, same per-field provenance, same snapshot.
GET /api/v1/providers/{npi}
curl https://fonteum.com/api/v1/providers/1003894328 \
-H "Accept: application/json"Response
{
"data": {
"npi": {
"value": "1003894328",
"_source": "CMS NPPES", "_snapshot": "2026-05-01"
},
"taxonomy_primary": {
"value": "207RC0000X",
"_source": "CMS NPPES", "_snapshot": "2026-05-01"
},
"enrollment_status": {
"value": "active",
"_source": "CMS PECOS", "_snapshot": "2026-05-01"
},
"mips_final_score": {
"value": 88.4,
"_source": "CMS QPP MIPS", "_snapshot": "2025-12-01"
},
"excluded": {
"value": false,
"_source": "OIG LEIE", "_snapshot": "2026-06-01"
}
},
"meta": {
"api_version": "v1",
"methodology_url": "https://fonteum.com/methodology"
}
}Each field is returned independently with its own source and snapshot date; a missing field is reported as missing, never imputed. Point-in-time history is available via /api/v1/history for any subject.
- 01Submit the NPI you are credentialing, or a roster of NPIs.
- 02Each field returns with its federal source and snapshot date — identity, taxonomy, enrollment, quality score, exclusion flag.
- 03Reconcile against your internal record; fields that are stale or mismatched are flagged with their as-of date.
- 04Pull the point-in-time view to reproduce the record exactly as it stood on the date of the original credentialing decision.
- 05Export the enriched record with per-field provenance straight into the credentialing file.
Sample audit-evidence artifact
PROVIDER ENRICHMENT — CREDENTIALING RECORD
NPI ................. 1003894328
Taxonomy (primary) .. 207RC0000X [NPPES · 2026-05-01]
Medicare enrollment . active [PECOS · 2026-05-01]
MIPS final score .... 88.4 [CMS QPP · 2025-12-01]
Exclusion flag ...... none [OIG LEIE · 2026-06-01]
Record as-of ........ 2026-06-17 (point-in-time available)
Methodology ......... providers/v1
Every field above carries its own source and snapshot date.The point-in-time view reproduces a provider's record as it stood on any past date — the evidence a re-credentialing file or a directory-accuracy audit needs.
Proof — not logos
Every field traces to a public source row.
Providers
Unique NPIs enumerated from the CMS NPI Registry — the identity backbone every enriched field hangs from.
PECOS enrollments
Medicare enrollment records joined by NPI, refreshed on the CMS release cadence with the snapshot date on every field.
Quality scores
CMS MIPS final scores attached where reported — a federal measure, cited to its source, never a Fonteum rating.
providers/v1
Pinned methodology
The methodology version is stamped at fetch time and reproducible months later for an audit of how the record was built.
“We do not tell you a provider is good. We tell you what the federal record says, where it came from, and when.”
CREDENTIALING & ENRICHMENT
Enrich a roster against the federal record, field by field.
Questions
Before the security questionnaire.
How is this different from buying an NPPES extract?
An extract is a flat snapshot with no record of when each field was true. Fonteum re-derives every field from NPPES, PECOS, and CMS quality files, attaches the source and snapshot date to each field, and keeps the history — so you can show what the record said on the date you credentialed against it.
Can I see what a provider record looked like on a past date?
Yes. The record is bitemporal: query any NPI as it stood on any past date. For re-credentialing or an audit, you can reproduce the exact field values and sources you relied on at the time, not just today's values.
Which fields do you enrich?
Identity and taxonomy from NPPES, Medicare enrollment status from PECOS, MIPS quality scores from CMS QPP, plus exclusion and sanction flags. Each field returns independently with its own source, snapshot date, and confidence — gaps are reported as gaps, never filled with a guess.
How fresh is the data?
Each source refreshes on its own cadence — NPPES and PECOS on their CMS release schedule, QPP annually — and every field carries its last-checked timestamp. A source running behind its refresh SLA is flagged in the response rather than served silently as current.
Do you assert that a provider is credentialed?
No. Fonteum returns source-backed facts — enrollment status, taxonomy, exclusion flags — with full provenance. The credentialing decision is yours. We never apply a trust label of our own; we show you the federal record and where it came from.
Go deeper
The data and research behind the record.
Solutions
All solutions — by use case & buyer →
Data catalog
NPPES provider registry →
Data catalog
CMS PECOS Medicare enrollment →
Research
Provider directory accuracy 2026 →
Research
MIPS score distribution by specialty →
Use case
Exclusion & sanctions screening →
Use case
Audit evidence & defensible programs →
For developers
Fonteum for developers & AI teams →
For compliance
Fonteum for compliance & risk teams →
FONTEUM · CREDENTIALING
Enrich provider data on public records only. No PHI.