Provider data is everywhere. Verified provider data is rare.
It lives in spreadsheets, disconnected systems, and siloed departmental databases. It flows through workflows, manually or through automation, and is often stale, siloed, or simply wrong. Externally, the challenge compounds: thousands of disparate state and federal primary sources, no universal industry-wide standards, and antiquated data access.
The result is an industry rich in information but lacking a foundational source of truth.
This creates risk for payers across credentialing, compliance, network integrity, and member satisfaction. One -stop-shop credentialing platforms fall short, leaving critical gaps in eligibility data. CVOs were built for periodic verification, but today’s health systems require intelligence that evolves along with them.
The answer is a verified data layer that connects everything else.
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Introducing DynamicNPI®
DynamicNPI is ProviderTrust’s verified provider data source, connecting disparate primary source information directly to NPI numbers and delivering a fully verified provider profile into your workflow of choice in 0.5 seconds.
- 360-degree provider eligibility
- Data for all departments
- Seamless integration
- Ongoing monitoring
- NCQA-certified automation
- Expiration tracking
Primary source verification at the speed your workflows need.
DynamicNPI Instant Verification requires only one input, an NPI, to run simultaneous checks across most required primary sources. Verified results arrive in under half a second.
DynamicNPI Verified Profiles Include:
- State License Verifications: Board Actions & Expiration Tracking
- DEA and/or CDS Registration
- OIG, SAM, All State Medicaid Exclusion/Sanctions Lists
- CMS Preclusion List
- NPI Validation (NPPES)
- American Board of Medical Specialties (ABMS)
- OFAC SDN List
- Medicare Opt-Out
- Work History
- Malpractice Certificate/PLI
- Education Verification
- Malpractice History (NPDB)*
- SSDMF*
- National Student Clearinghouse*
- Non-ABMS Certifications (ADA, AMA, etc.)*
*Can be verified and delivered by ProviderTrust with additional data elements
Never miss an eligibility change.
Beyond initial credentialing, DynamicNPI Monitoring provides NCQA-certified, continuous visibility into your provider network. Your team is only alerted when a provider’s eligibility status changes in a meaningful way.
Proposed NCQA requirements are calling for shorter verification windows (60 days). DynamicNPI Monitoring keeps your credentialing packet current, with up-to-daily alerts on upcoming license and credential expirations in between credentialing cycles.
- Adverse event alerts. Get notified of sanctions, exclusions, suspensions, or license expirations.
- Member safety first. Keeps your networks free of excluded or ineligible providers, reducing exposure to fraud, waste, and abuse.
- Credential expiration tracking. Up-to-daily alerts on upcoming license and credential expirations between credentialing cycles.
- 360-degree provider eligibility. Continuous verification and ongoing monitoring with real-time primary source updates and documentation.
Built to power your workflows.
DynamicNPI’s verified provider data is accessible via API, integrating seamlessly into your existing workflows and applications in real time. Instantly access a provider’s verified profile at any point in your workflow, then add them to continuous monitoring — no manual intervention or file uploads required.
From credentialing to compliance to provider directory, a single API connection puts ProviderTrust’s entire verified data platform to work across your organization.
The data strategy others are still trying to build.
ProviderTrust has been joined by countless emerging technology companies looking to solve the problems we’ve been tackling for more than 15 years. Many are well-funded and use-case focused, but they lack the one thing that makes all the difference: more than a decade of historical data and the depth of knowledge to holistically solve the eligibility data challenge.
Our proprietary data enrichment strategy prioritizes precision and speed, reducing the time your teams need to spend resolving eligibility issues. That strategy is what powers DynamicNPI, and it’s what no emerging competitor can replicate.
Frequently Asked Questions
What is DynamicNPI®?
DynamicNPI is ProviderTrust’s verified provider data source, built on more than 15 years of primary source data infrastructure. With just an NPI, it delivers a fully verified provider profile in under half a second. It’s designed for healthcare payers who need NCQA-certified verification and continuous monitoring across their provider networks.
How does DynamicNPI verify provider credentials?
When an NPI is entered, DynamicNPI simultaneously queries every required primary source, including state licensing boards across all 50 states, DEA, OIG, SAM.gov, ABMS, CMS, CAQH, and more, and returns a fully verified profile in under 0.5 seconds.
Is DynamicNPI NCQA-certified?
Yes. ProviderTrust is NCQA-certified in six areas of primary source verification: DEA Registration, Medical Board Sanctions, Medicare/Medicaid Sanctions, Ongoing Monitoring of Sanctions, Board Certification Status, and Licensure Verification. Additional NCQA certifications are pending.
What data sources does DynamicNPI cover?
DynamicNPI covers state license verifications across all 50 states, board certifications, DEA/CDS registrations, OIG and SAM.gov exclusions, all state Medicaid exclusion and sanction lists, Medicare Opt Out, CMS Preclusion List, NPI validation (NPPES), OFAC SDN List, ABMS, CAQH (Education, Work History, COI), and NPDB.
How does DynamicNPI differ from a traditional CVO?
Traditional CVOs rely on manual, batch-processed verification. Credentials are checked periodically, the administrative burden is high, and turnaround is slow. DynamicNPI delivers instant, automated verification and continuous monitoring through a single API, built on 15+ years of proprietary data. It’s not a full-service CVO. It’s a verified data source that speeds up credentialing, improves accuracy, and enables interoperability with the systems your team already uses.
How does DynamicNPI integrate with existing systems?
DynamicNPI’s verified provider data is accessible via an API, enabling direct integration with your credentialing, operations, compliance, and directory workflows. No rip-and-replace required. Results are delivered inside the systems your team already uses.
What is DynamicNPI Monitoring?
DynamicNPI Monitoring is the continuous monitoring capability within DynamicNPI. Once a provider is added, ProviderTrust tracks their eligibility status in real time and alerts your team only when a meaningful change occurs, such as a sanction, exclusion, suspension, or credential expiration.
