PECOS Medicare Enrollment Pre-Check API Reference

Beta. Checks one provider's draft CMS-855I, 855B or 855S enrollment, revalidation or change as JSON, with one live NPPES lookup per run. Product page and free test form.

Endpoint

Request

Start from the sample draft; the practice and NPI are invented.

Other conditions: soleProprietor (855S run by a sole proprietor: individual name, individual signs).

Supporting documents

A document is required when its condition is true, or always, or unless the named condition is true. Keys not used by the form are reported once as a warning and ignored.

Report

Rule IDs

Source keys, as returned in every report:

• CMS-855I (05/23) enrollment application for physicians and non-physician practitioners
• CMS-855B (12/2025) enrollment application for clinics, group practices and certain other suppliers
• CMS-855S (12/23) enrollment application for DMEPOS suppliers
• 42 CFR part 424, subpart P: enrollment (424.510), revalidation (424.515), rejection (424.525), deactivation (424.540)
• 42 CFR 424.57: DMEPOS supplier standards
• CMS: Medicare revalidations
• CMS: NPI check digit
• NPPES NPI Registry

Not checked

• What the Medicare Administrative Contractor reviewer sees and decides, including site visits, background checks and fingerprinting.
• Whether licenses, registrations and insurance are valid with the issuing board or carrier. Expiration dates are checked only as you entered them.
• Ownership, managing employee and final adverse action details, and PECOS screens not covered by the input.
• The CMS-855A, CMS-855R, CMS-855O and CMS-20134 forms.
• Whether the documents you marked as ready are the right ones and are complete.

The NPPES lookup

When the NPI passes the format and check digit tests, each run makes one request to the public NPPES NPI Registry API (version 2.1) with that NPI and nothing else. The answer is used to run the registry rules and then discarded: it is not stored, cached between runs or included in the response. If the registry cannot be reached, the call returns HTTP 503 with the code registry_unavailable and is not charged.

Example responses

A paid pre-check of the sample draft (report shortened), and the findings from a demo run of the sample with errors. Both generated by running the real endpoint code; because the sample NPI is invented, the registry answer in these two examples is simulated.

{
  "requestId": "7f3c2a1e-5b8d-4c6f-9e0a-1d2b3c4d5e6f",
  "api": "pecos-enrollment-precheck",
  "mode": "paid",
  "charged": true,
  "priceCents": 2500,
  "balanceCents": 7500,
  "report": {
    "schemaVersion": 1,
    "status": "PASS",
    "enrollmentType": "855B",
    "applicationReason": "initial",
    "asOf": "2026-10-05",
    "processingWindowDays": 90,
    "windowEnds": "2027-01-03",
    "registry": {
      "queried": true,
      "source": "NPPES NPI Registry API, version 2.1 (queried live during the run)",
      "note": "Queried live for this run only. Registry data is not stored, cached or returned."
    },
    "counts": {
      "practiceLocations": 1,
      "credentials": 1,
      "documentsRequired": 3,
      "documentsMissing": 0
    },
    "readiness": [
      {
        "item": "npi",
        "label": "NPI is well formed and active in NPPES as the right type",
        "status": "ready"
      },
      {
        "item": "names",
        "label": "Legal name matches the IRS name and the NPPES record",
        "status": "ready"
      },
      {
        "item": "taxonomy",
        "label": "Taxonomy codes match the NPPES record",
        "status": "ready"
      },
      {
        "item": "addresses",
        "label": "Practice locations are complete, with ZIP+4",
        "status": "ready"
      },
      {
        "item": "credentials",
        "label": "Licenses, registrations and insurance stay current through the processing window",
        "status": "ready"
      },
      {
        "item": "documents",
        "label": "Supporting documents for this form are ready",
        "status": "ready"
      },
      {
        "item": "signatures",
        "label": "The right person is set to sign",
        "status": "ready"
      },
      {
        "item": "revalidation",
        "label": "Revalidation is not past its due date",
        "status": "not-applicable"
      }
    ],
    "findingCount": 0,
    "findingCounts": {
      "error": 0,
      "warning": 0
    },
    "ruleCounts": {},
    "findingsTruncated": false,
    "scope": "A pre-submission error check of the draft you sent. A clean pre-check does not guarantee that the enrollment will be approved, it is not an enrollment filing, and it is not legal advice.",
    "input": {
      "format": "json",
      "bytes": 907
    },
    "inputSha256": "7fc3172e9ff748bce5baad28ba32b74e0f6ef48f20cbccac14abf9239fc0bf14"
  }
}

[
  {
    "severity": "error",
    "ruleId": "PEC-ADDR-POBOX",
    "path": "/practiceLocations[0]/street1",
    "message": "A practice location must be a street address, not a P.O. box.",
    "source": "cms855b"
  },
  {
    "severity": "error",
    "ruleId": "PEC-CRED-EXPIRED",
    "path": "/credentials[1]/expirationDate",
    "message": "This item has already expired. Renew it before you submit."
  },
  {
    "severity": "error",
    "ruleId": "PEC-DOC-MISSING",
    "path": "/documents/cp575",
    "message": "Missing supporting document: IRS confirmation of the TIN and legal business name (for example CP-575) (Section 12 of the form).",
    "source": "cms855b"
  },
  {
    "severity": "error",
    "ruleId": "PEC-NAME-IRS",
    "path": "/provider/legalName",
    "message": "The legal business name does not match the IRS name you gave. CMS requires the name reported to the IRS.",
    "source": "cms855b"
  },
  {
    "severity": "error",
    "ruleId": "PEC-NPPES-NAME",
    "path": "/provider/legalName",
    "message": "The legal business name does not match the organization name on the NPPES record for this NPI. The CMS-855B asks for the same legal business name and TIN used to get the NPI.",
    "source": "cms855b"
  }
]

Errors

See the shared error table. Rejected with HTTP 400 and not charged: a body that is not a JSON object, an enrollmentType other than 855I, 855B or 855S, a missing provider, wrong value types, an out-of-range processingWindowDays. HTTP 503 registry_unavailable: NPPES could not be reached; not charged. Example (HTTP 400):

{
  "error": {
    "code": "input_error",
    "message": "enrollmentType must be one of 855I, 855B or 855S. Other CMS-855 forms are not supported yet.",
    "requestId": "7f3c2a1e-5b8d-4c6f-9e0a-1d2b3c4d5e6f",
    "charged": false
  }
}

Code samples

curl -X POST "https://www.spreadrun.com/api/v1/pecos-enrollment-precheck" \
  -H "Authorization: Bearer $SPREADRUN_API_KEY" \
  -H "Content-Type: application/json" \
  --data-binary @enrollment_draft.json