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A Guide to Verifying Healthcare Provider Credentials

When seeking healthcare services, patients want and deserve to ensure they choose qualified medical providers who have the proper education, training, licensure, certification, and verified experience to deliver safe, high-quality treatment. Conducting thorough due diligence by proactively verifying credentials is an important and necessary step for patients or their advocates to take in order to validate a provider’s background, qualifications and competence to provide care.

The Importance of Confirming Education, Residency and Fellowships

Patients have a right to ask any prospective provider about their educational background, medical school attended, postgraduate residency training hospital(s), and any subsequent fellowship programs completed in a specialty area. This helps assess the physician or clinician’s foundational medical knowledge base, hands-on clinical experience gained, and the intensity and duration of their training.

Many providers list details about their medical school education, residency completion, and fellowships prominently on their websites or in practice biographies. Patients can take it one step further and verify advanced degrees by directly contacting the registrar’s office at listed medical schools and institutions. Confirming residency and fellowship details involve contacting the prior training hospital or program directly to validate completion status and graduation years.

Checking Current Licensure Status and Disciplinary Records

All practicing medical providers must meet state licensing requirements and maintain licensure in active standing in order to legally provide clinical services in that state. Medical licenses show that required levels of education, postgraduate training, professional examinations, and certifications have been achieved initially but they must also be kept current through renewal processes.

Patients can and should verify a prospective provider’s license directly through state medical board websites, which provide license verification services online. Searches should show the provider holds an active, unrestricted license to practice in the same state where they will see patients.

Looking Up Board Certification for Specialists

For medical providers practicing in a specialty area, having certification from the relevant specialty board provides validation that they have met stringent qualifications and shows voluntary assessment of their deep expertise by peers. Patients considering specialists can use the American Board of Medical Specialties (ABMS) website to independently confirm the provider’s board certification status, including issue date, expiration date and any disciplinary history such as probation or suspension.

Utilizing the NPI Registry and Other Resources to Validate Identities

An important universal identifier that can assist in credentials research is the National Provider Identifier (NPI) number that is assigned to each practicing medical provider in the United States and used for billing, reimbursement, and insurance purposes. Providers submit their credentials to obtain the unique NPI number. The people at say that patients can easily use tools such as NPI lookup to independently confirm the identity, demographics, and practice location of a provider they plan to see. Patients can enter the provider’s name to retrieve the NPI, then check that no exclusions such as disciplinary actions or malpractice claims are present on the record.

Looking into Work History Patterns and Experience

Inquiring where and when a prospective provider has worked and researching any details available offers useful insight into the extent of their professional experience, time in practice, clinical environment exposure and past affiliations. Patients may reasonably ask providers directly about their prior practice locations and tenures and then do further verification by contacting those entities.


While verifying provider credentials thoroughly does require significant diligent effort on the part of patients, it is a very worthwhile investment to gain confidence in the clinical qualifications, expertise, and trustworthiness of providers before proceeding with treatment. Performing proper due diligence helps reduce risks and avoid potential missteps of placing care in the wrong hands.

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