A tool by Firecrawl · uses 8 tools · Healthcare

Provider address and exclusion field check

Use when a health plan special investigations unit analyst gets a tip about a suspicious provider. Compares the provider's NPI addresses with what is actually at those locations on the map, reads the business registration behind the practice, screens federal and state Medicaid exclusion lists and looks for related federal court cases, producing an investigation lead memo.

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# Provider address and exclusion field check

For one NPI under review. Billing fraud often leaves an address with no clinic behind it or a freshly formed entity; this checks both before a field visit.

## 1. What the provider claims

1. Read @[NPI Registry · Provider](alexandria:npiregistry-cms-hhs-gov/providers/provider) (npi): entity type, enumeration date, last update, taxonomies, authorised official for organisations.
2. List every practice site with @[NPI Registry · Locations](alexandria:npiregistry-cms-hhs-gov/providers/locations). Recent changes and many sites for a small practice are worth noting.

## 2. What is really there

3. For each address, search @[Maps · Search](alexandria:firecrawl-maps/businesses/search) (the street address). Record whether a medical business appears, what kind and whether it has reviews. A mailbox store, residence or unrelated business is a flag.

## 3. Who is behind it

4. Look up the practice entity in its state registry, for example @[Georgia eCorp · Search businesses](alexandria:ecorp-sos-ga-gov/entities/search_businesses) then @[Georgia eCorp · Get business](alexandria:ecorp-sos-ga-gov/entities/get_business), or @[Florida Sunbiz · Search](alexandria:search-sunbiz-org/entities/search). Note formation date versus NPI enumeration date and officers who are not clinicians.

## 4. History

5. Screen the provider, entity and officers with @[OpenSanctions · Search entities](alexandria:opensanctions-org/sanctions-screening/search_entities) (datasets us_sam_exclusions plus state Medicaid exclusion datasets).
6. Search @[CourtListener · Search dockets](alexandria:courtlistener-com/dockets/search_dockets) (party_name) for health care fraud or False Claims Act cases.

## Write the lead memo

- **Findings table:** address, what is there, registry facts, exclusion hits, dockets.
- **Indicators:** each with its source; state clearly that these are leads, not conclusions.
- **Next steps:** records request, site visit, claims review.
- **Sources:** NPI, map results, registry ids, OpenSanctions ids, docket numbers. Say what could not be found.
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Provider address and exclusion field check, a tool for AI agents | Firecrawl Alexandria