What provider data does Fonteum provide for payer credentialing?

Fonteum exposes loaded NPPES, OIG LEIE, and PECOS records within a graph of the documented federal-source catalog. In the July 12 production audit, NPPES had a newest system date of June 10, PECOS a newest source-release date of June 18, and OIG LEIE a newest source-release date of May 8. Source, date, and limitation fields vary by response; Fonteum is a screening data layer, not a credentialing decision.

How often is the OIG LEIE exclusion data refreshed?

OIG publishes the LEIE monthly. Fonteum's loaded 68,055-row release was dated May 8, 2026 when checked July 12, so it may trail the official file. Source and observation fields vary by response. Confirm consequential status against the current OIG list.

Does Fonteum's data meet CMS requirements for provider directory accuracy?

Fonteum exposes loaded NPPES, PECOS, and selected Care Compare data, but it does not certify directory accuracy or establish regulatory compliance. In the July 12 audit, NPPES had a June 10 newest system date, PECOS a June 18 newest source date, and checked Care Compare modules a May 7 newest source date. Fields and provenance metadata vary by response.

Can I access Fonteum provider data via API for automated credentialing workflows?

Fonteum exposes Practitioner, PractitionerRole, Organization, Location, and HealthcareService resources through its FHIR R4 surface, plus an NDJSON bulk-export workflow. Source and observation metadata varies by resource and field; the CapabilityStatement does not establish universal provenance or current coverage.

How does field-level provenance change a credentialing audit?

Fonteum can expose source, observation-date, and limitation fields alongside loaded NPPES, OIG, and PECOS values where those fields are present. Coverage varies by endpoint and record, and no provenance fact currently links deterministically to a signature. Consequential credentialing and exclusion decisions still require confirmation against current primary sources.

Is Fonteum's credentialing data free, and what does the pilot tier add?

Public NPPES, OIG LEIE, and PECOS records are available through Fonteum's public surfaces and documented APIs. The scoped pilot tier, starting at $2,500/mo, adds network-scoped exports and integration support. Source and observation metadata is included where the selected response supplies it; it is not universal.

FONTEUM · USE CASE · PAYER CREDENTIALING

LEIE exclusions

Provider credentialing data, auditable to the federal source.

Loaded CMS NPPES, OIG LEIE, and CMS PECOS records in one graph, with source metadata where the response supplies it.

Request access →

Federal source stack

Three federal sources. One provenance graph.

active providers
CMS NPPES
NPI identity backbone
active providers (8.9M total records) — provider taxonomy code, practice address, entity type, enumeration date. Distributed as a weekly full-replacement file. The authoritative federal identifier for individual practitioners and organizations.
Source documentation →
LEIE rows
OIG LEIE
Federal exclusion flag
OIG HHS List of Excluded Individuals and Entities — loaded rows from the May 8, 2026 source release when checked July 12. Exclusion fields and source metadata vary by record.
Source documentation →
Active enrollment status
CMS PECOS
Medicare enrollment status
CMS PECOS Physician and Practitioner Enrollment File — Medicare enrollment indicator, provider type, and reassignment data. A PECOS row joins to NPPES only when it publishes the same NPI; an NPI without a matching PECOS row does not establish Medicare enrollment.
Source documentation →

Why source provenance matters for credentialing

Auditable to the federal source — not a vendor's derived list

CMS expects primary-source screening

The CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and the Provider Directory Accuracy requirements expect health plans to maintain directory data sourced from NPPES and PECOS. Fonteum makes loaded federal records accessible across active providers with source metadata where available. Fonteum's NPPES table had a newest system date of June 10, 2026 when checked July 12; that is not a source-release date or a claim that the table is current.

OIG exclusion screening, monthly cadence

CMS requires Medicare Advantage organizations and Medicaid plans to screen providers against the OIG LEIE monthly. OIG publishes monthly, but Fonteum's loaded release was dated May 8, 2026 when checked July 12. Results expose available source and observation fields; no provenance fact currently links deterministically to a signature. Confirm consequential status against the current OIG file.

FHIR R4 for automated workflow integration

Fonteum's FHIR R4 surface exposes Practitioner, PractitionerRole, Organization, Location, and HealthcareService resources. The CapabilityStatement lists advertised resources and search parameters; it does not establish universal source metadata or current coverage.

How it works

From federal portal to auditable credentialing record

Step 1 / Ingest

Ingest

Publisher cadence and loaded dates are separate. In the July 12 production audit, NPPES had a June 10, 2026 newest system date, PECOS had a June 18 source date, and the table had a May 8 source date.

Step 2 / Provenance

Provenance

Responses expose source, observation-date, and limitation fields where those values are populated. They are nullable and vary by dataset; they do not establish universal signature linkage or a completed primary-source check.

Step 3 / Deliver

Deliver

Screening data is available at /research and /sanctions, through the FHIR R4 surface, and via HL7 bulk $export. Scoped pilot exports start at $2,500/mo; source metadata varies by record.

FAQ

Common questions

What provider data does Fonteum provide for payer credentialing?: Fonteum exposes loaded NPPES, OIG LEIE, and PECOS records within a graph of the documented federal-source catalog. In the July 12 production audit, NPPES had a newest system date of June 10, PECOS a newest source-release date of June 18, and OIG LEIE a newest source-release date of May 8. Source, date, and limitation fields vary by response; Fonteum is a screening data layer, not a credentialing decision.
How often is the OIG LEIE exclusion data refreshed?: OIG publishes the LEIE monthly. Fonteum's loaded release was dated May 8, 2026 when checked July 12, so it may trail the official file. Source and observation fields vary by response. Confirm consequential status against the current OIG list.
Does Fonteum's data meet CMS requirements for provider directory accuracy?: Fonteum exposes loaded NPPES, PECOS, and selected Care Compare data, but it does not certify directory accuracy or establish regulatory compliance. In the July 12 audit, NPPES had a June 10 newest system date, PECOS a June 18 newest source date, and checked Care Compare modules a May 7 newest source date. Fields and provenance metadata vary by response.
Can I access Fonteum provider data via API for automated credentialing workflows?: Fonteum exposes Practitioner, PractitionerRole, Organization, Location, and HealthcareService resources through its FHIR R4 surface, plus an NDJSON bulk-export workflow. Source and observation metadata varies by resource and field; the CapabilityStatement does not establish universal provenance or current coverage.
How does field-level provenance change a credentialing audit?: Fonteum can expose source, observation-date, and limitation fields alongside loaded NPPES, OIG, and PECOS values where those fields are present. Coverage varies by endpoint and record, and no provenance fact currently links deterministically to a signature. Consequential credentialing and exclusion decisions still require confirmation against current primary sources.
Is Fonteum's credentialing data free, and what does the pilot tier add?: Public NPPES, OIG LEIE, and PECOS records are available through Fonteum's public surfaces and documented APIs. The scoped pilot tier, starting at $2,500/mo, adds network-scoped exports and integration support. Source and observation metadata is included where the selected response supplies it; it is not universal.

Request access →

Request a credentialing data pilot.

This page covers the payer-specific angle. For the full dual-buyer walkthrough — the developer API and the compliance workflow side by side — see the credentialing & provider-data enrichment use case. Scope a custom NPPES + OIG LEIE + PECOS export for your provider network. Free public data at /research and /sanctions. Pilot tier from $2,500/mo.

Request access →or read the FHIR R4 docs →

FONTEUM · PILOT

Run a 90-day pilot. Public data only. No PHI.

Request access → Read the methodology

Provider credentialing data, auditable to the federal source.

Loaded CMS NPPES, OIG LEIE, and CMS PECOS records in one graph, with source metadata where the response supplies it.

Request access →

Federal source stack

Three federal sources. One provenance graph.

active providers
CMS NPPES
NPI identity backbone
active providers (8.9M total records) — provider taxonomy code, practice address, entity type, enumeration date. Distributed as a weekly full-replacement file. The authoritative federal identifier for individual practitioners and organizations.
Source documentation →
LEIE rows
OIG LEIE
Federal exclusion flag
OIG HHS List of Excluded Individuals and Entities — loaded rows from the May 8, 2026 source release when checked July 12. Exclusion fields and source metadata vary by record.
Source documentation →
Active enrollment status
CMS PECOS
Medicare enrollment status
CMS PECOS Physician and Practitioner Enrollment File — Medicare enrollment indicator, provider type, and reassignment data. A PECOS row joins to NPPES only when it publishes the same NPI; an NPI without a matching PECOS row does not establish Medicare enrollment.
Source documentation →

Why source provenance matters for credentialing

Auditable to the federal source — not a vendor's derived list

CMS expects primary-source screening

OIG exclusion screening, monthly cadence

FHIR R4 for automated workflow integration

How it works

From federal portal to auditable credentialing record

Step 1 / Ingest

Ingest

Publisher cadence and loaded dates are separate. In the July 12 production audit, NPPES had a June 10, 2026 newest system date, PECOS had a June 18 source date, and the table had a May 8 source date.

Step 2 / Provenance

Provenance

Step 3 / Deliver

Deliver

Screening data is available at /research and /sanctions, through the FHIR R4 surface, and via HL7 bulk $export. Scoped pilot exports start at $2,500/mo; source metadata varies by record.

FAQ

Common questions

What provider data does Fonteum provide for payer credentialing?: Fonteum exposes loaded NPPES, OIG LEIE, and PECOS records within a graph of the documented federal-source catalog. In the July 12 production audit, NPPES had a newest system date of June 10, PECOS a newest source-release date of June 18, and OIG LEIE a newest source-release date of May 8. Source, date, and limitation fields vary by response; Fonteum is a screening data layer, not a credentialing decision.
How often is the OIG LEIE exclusion data refreshed?: OIG publishes the LEIE monthly. Fonteum's loaded release was dated May 8, 2026 when checked July 12, so it may trail the official file. Source and observation fields vary by response. Confirm consequential status against the current OIG list.
Does Fonteum's data meet CMS requirements for provider directory accuracy?: Fonteum exposes loaded NPPES, PECOS, and selected Care Compare data, but it does not certify directory accuracy or establish regulatory compliance. In the July 12 audit, NPPES had a June 10 newest system date, PECOS a June 18 newest source date, and checked Care Compare modules a May 7 newest source date. Fields and provenance metadata vary by response.
Can I access Fonteum provider data via API for automated credentialing workflows?: Fonteum exposes Practitioner, PractitionerRole, Organization, Location, and HealthcareService resources through its FHIR R4 surface, plus an NDJSON bulk-export workflow. Source and observation metadata varies by resource and field; the CapabilityStatement does not establish universal provenance or current coverage.
How does field-level provenance change a credentialing audit?: Fonteum can expose source, observation-date, and limitation fields alongside loaded NPPES, OIG, and PECOS values where those fields are present. Coverage varies by endpoint and record, and no provenance fact currently links deterministically to a signature. Consequential credentialing and exclusion decisions still require confirmation against current primary sources.
Is Fonteum's credentialing data free, and what does the pilot tier add?: Public NPPES, OIG LEIE, and PECOS records are available through Fonteum's public surfaces and documented APIs. The scoped pilot tier, starting at $2,500/mo, adds network-scoped exports and integration support. Source and observation metadata is included where the selected response supplies it; it is not universal.

Request access →

Request a credentialing data pilot.

Request access →or read the FHIR R4 docs →

FONTEUM · PILOT

Run a 90-day pilot. Public data only. No PHI.

Request access → Read the methodology